芬太尼贴剂用于外科术后镇痛的临床研究

CLINICAL RESEARCH ON POSTOPERATIVE ANALGESIC EFFECT OF FENTANYL

目的 探讨芬太尼缓释透皮贴剂用于外科术后镇痛的安全性和时效关系。方法 将 12 3例择期上腹部手术病人随机分成 4组 :T1组 2 9例 ,T2组 31例 ,T3组 33例 ,C组 30例。T1、T2、T3组分别于术前 1h、6h、12h在胸骨上端皮肤贴 5mg芬太尼贴剂 2片 (药物释放速度 10 0 μg h) ,C组贴不含药物的贴片。术毕病人清醒后记录各组病人疼痛分值 (视觉模拟评分法VAS) ,盐酸哌替啶用量和恶心、呕吐、呼吸困难、眩晕、便秘、尿潴留等副反应的发生率。结果 镇痛效果 :4组VAS在各个时段相比具有显著性差异。T1、T2、T3组VAS与C组比较 ,均有显著性差异 (P <0 .0 1)。T2组 4h、8h时段的VAS评分均优于T1组 ,T2、T3组 ,每个评价时段的VAS无显著性差异。T1组与T2组相比 ,在恶心、呕吐、烦躁等方面具有显著性差异 (P <0 .0 5 ) ,在其他方面无显著性差异。结论 10 0 μg h芬太尼透皮贴剂术前 6h给药用于上腹部手术后镇痛是安全的 。

Objective to explore the security and time-effect relationship of security of fentanyl in postoperative analgesia.Methods 123 cases of espigastric surgery were randomly divided into Group T1 of 29 cases,Group T2 of 31 cases,Group T3 of 33 cases and Group C of 30 cases.2 patches of fentanyl application were put on the suprasternal region of each patients in Group T1,T2,and T3,just 1,6 and 12 hours before operations with the drug release rate being 100ug/h.No fentanyl applications were used in Group C.The pain indexes,dosage of pethidine and the incidence of side effects such as nausea,vomiting,dyspneic respiration,faint,constipation and uroschesis were recorded after consciousness.Results According to the visual simulating surveys,there existed significant difference between Group C and Group T1,T2,and T3(P<0.01).Better effects at the 4th and 8th hour after treatment could be found in GroupT2 than in Group T1.There existed no significant difference at any fixed time between Group T2 and T3.The side effects in the four groups showed no obvious difference.Conclusion Fentanyl application at 100ug/h has proven to be safe and can produce best analgesic effects 6 hours before operation.