多瑞吉用于全麻术后镇痛的临床研究

TRANSDERML FENTANYL FOR THE RELIEF OF PAIN AFTER OPERATION UNDER GEN-ERAL ANESTHESIA

目的:探讨多瑞吉用于全麻术后镇痛的效能和安全性。方法:择期全麻腹部手术病人60例,随机分为两组,多瑞吉组（A组）30例,对照组（B组）30例。手术前9小时,A组左侧锁骨下贴1片50μg/h多瑞吉贴膜,B组予不含药物的贴片。术中两组均采用气管插管静吸复合麻醉,术后持续监测SpO2、RR、ECG、NBP,进行VAS评分、BCS评分、Ramsay评分,观察有无恶心、呕吐、瘙痒、尿潴留等副反应。结果:（1）镇痛效果,A组镇痛效果满意且优于B组（P<0.01）。（2）呼吸影响,两组病例均未出现SpO2低于90％。（3）副反应,恶心、呕吐、瘙痒、尿潴留发生率两组相似。结论:50μg/h多瑞吉用于全麻腹部手术是安全有效的,并且不明显增加副反应发生。

Objective: To evaluate the safety and efficacy of transdermal fentanyl to relieve pain after operation under general anesthesia. Method: 60 patients undergoing elective abdominal surgery under general anesthesia were randomly entered into two groups, durogesic group ( group A, 30 cases) and placebo group ( group B , 30 cases) . About 9 hours before operation, medicinal chart with fentanyl release 50μg/ h was set on the infraclavicular skin of group A and a sticking paper without medicament on the same position of group B. All patients experienced general anesthesia with midazolam, fentanyl, enflurane, and succinylcholine. After surgery, Sp02, RR, ECG and NBP were monitored continuously. VAS score, BCS score and Ramsay score were measured. The incidence of nausea, vomiting, pruritus, and urinary retention were measured. Result: (1)The analgesic effect was satisfactory in group A, and was significantly more effective than that in group B (P <0. 01 ) ; (2) The evidence of respiratory depression was not found in any patients; (3) There was no difference between two groups in the incidence of adverse effects such as nausea, vomiting, pruritus and urinary retention. Conclusions; Transdermal fentanyl (50μg/h) is safe and efficient in relieving pain after operation under general anesthesia. The postoperative analgesia did not obviouly increase the incidence of aversove side effects.