氢吗啡酮联合芬太尼用于颌面部手术后镇痛效果观察

ANALGESIC EFFECTS OF HYDROMORPHONE COMBINED FENTANYL ON POSTOPERATIVE ANALGESIA OF MAXILLOFACIAL SURGERY

目的:评价氢吗啡酮联合芬太尼用于颌面部手术患者术后自控静脉镇痛的效果。方法:40例择期行颌面部手术的患者随机分为氢吗啡酮+芬太尼(H)组和芬太尼(F)组,每组20例。两组术后均采用患者静脉自控镇痛的方式,F组芬太尼1.0mg;H组氢吗啡酮1.6mg+芬太尼0.5mg,记录术后2h、4h、8h、12h、24h的疼痛评分(VAS评分)和Ramsay镇静评分(RSS评分),观察恶心、呕吐、眩晕等不良反应的发生情况。结果:两组患者术后各时间点VAS评分、RSS评分比较差异无统计学意义(P>0.05)。镇痛治疗期间H组患者恶心呕吐、眩晕的发生率明显低于F组(P<0.05)。结论:氢吗啡酮联合芬太尼与单用芬太尼用于颌面部手术术后镇痛的效果相当,但不良反应发生率明显较低,更适用于颌面部手术术后镇痛。

Objective：To evaluate the effects of hydromorphone combined fentanyl on postoperative patient control intravenous analgesia（PCIA） of maxillofacial surgery patients. Methods：40 cases selective maxillofacial surgery patients were randomly divided into hydromorphone combined fentanyl（H） group and fentanyl（F） group（n=20）. These 2 groups all used PCIA： patients in H group used hydromorphone（1.6mg） combined fentanyl（0.5mg）; patients in F group only used fentanyl（1.0mg）. The VAS score and RSS score of patients in 2 groups were recorded 2h, 4h, 8h, 12 h, 24 h after operation respectively; as well as adverse effects. Results：There had no statistical signifi cance about VAS score and RSS score of 2 groups at each time point after operation（P〉 0.05）. The incidence rate of adverse effects（nausea, vomiting and dizziness） of H group were obviously lower than that of F group（P〈0.05）. Conclusions：The analgesic effects of hydromorphone combined fentanyl is same as fentanyl after maxillofacial surgery, but adverse effects are fairly lower. So hydromorphone combined fentanyl is more comfortable and safer for maxillofacial surgery.