目的观察瑞芬太尼与丙泊酚混合溶液自控镇痛在老年患者结肠镜检查中的效果及不良反应,探讨其安全性及有效性。方法选取2015年5月-9月择期行无痛肠镜检查的老年患者60例,随机分为自控镇痛镇静（PCAS）组和静脉复合麻醉（TIVA）组,每组30...目的观察瑞芬太尼与丙泊酚混合溶液自控镇痛在老年患者结肠镜检查中的效果及不良反应,探讨其安全性及有效性。方法选取2015年5月-9月择期行无痛肠镜检查的老年患者60例,随机分为自控镇痛镇静（PCAS）组和静脉复合麻醉（TIVA）组,每组30例。PCAS组：接自控镇痛泵,负荷剂量设为0.05 m L/kg,继之以0.6 m L/（kg·h）的速度持续泵入丙泊酚与瑞芬太尼的混合药液,待负荷量输注完毕3 min后即可开始检查,术中患者根据自身感觉按压自控手柄,自控剂量为1 m L,锁定时间为1 min。TIVA组：静脉缓慢推注芬太尼1μg/kg,咪达唑仑0.02 mg/kg,2 min后缓慢推注丙泊酚0.8-1.0 mg/kg,待患者意识消失呼之不应即可开始检查。结果两组患者的平均血压在组内各时间点均较麻醉前下降,差异有统计学意义（P〈0.05）;TIVA组的平均血压下降比PCAS组更明显,差异有统计学意义（P〈0.05）。两组患者的心率、脉搏血氧饱和度及呼吸频率在组内各时间点均较麻醉前下降,差异有统计学意义（P〈0.05）;呼气末二氧化碳则较麻醉前升高,但组间比较差异均无统计学意义（P〉0.05）。两组患者的诱导时间、进镜至回盲部的时间以及总检查时间比较差异均无统计学意义（P〉0.05）,但从检查结束至OAA/S评分达5分和Aldrete评分达9分时间相比,PCAS组显著短于TIVA组,差异有统计学意义（P〈0.05）。结论瑞芬太尼与丙泊酚混合溶液用于PCAS较传统的静脉麻醉为老年患者提供更好的循环稳定性,麻醉恢复更迅速,可能成为老年患者肠镜检查的理想镇静镇痛方式。展开更多
Objective To observe the analgesia effectiveness and safety of electroacupuncture at Neimadian （内麻点 Extra） after abdominal surgery. Methods One hundred and twenty patients with routine abdominal surgery were rand...Objective To observe the analgesia effectiveness and safety of electroacupuncture at Neimadian （内麻点 Extra） after abdominal surgery. Methods One hundred and twenty patients with routine abdominal surgery were randomly divided into an acupuncture group and a medication group, 60 cases in each group. The acupuncture group was treated with electroacupuncture at Neimadian （内麻点 Extra）, which was located on the medial side of lower leg, 7 cun above the medial malleolus and about 0.5 cun from post edge of tibia. The medication group was treated with patient-controlled intravenous analgesia （PCIA） with Sufentanil. After the treatment, the Visual Analogue Scale （VAS）, the security, the analgesic effect and plasma β-endorphin content in the two groups were compared.Results The postoperative VAS scores at 2, 4, 8, 16, 24 and 48 h in the acupuncture group were lower than those in the medication group （all P〈0.05）. The analgesic effects at 2, 4, 16 and 24 h after surgery in the acupuncture group were superior to those in the medication group （P〈0.05, P〈0.01）. The plasma β-endorphin contents at 0, 8, 16 and 48 h after surgery in both groups were increased, and the acupuncture group was superior to the medication group （all P〈0.05）. The security class after surgery in the acupuncture group was higher than that in the medication group （P〈0.05）. Two cases in acupuncture group stopped treatment due to overstress and fear of needling, 24 cases in medication group presented adverse reactions, among them, 3 cases stopped the treatment due to nausea, vomiting. Conclusion The analgesic effect and safety of electroacupuncture at Neimadian （内麻点 Extra） after abdominal surgery are superior to those of the PCIA with Sufentanil.展开更多
文摘目的观察瑞芬太尼与丙泊酚混合溶液自控镇痛在老年患者结肠镜检查中的效果及不良反应,探讨其安全性及有效性。方法选取2015年5月-9月择期行无痛肠镜检查的老年患者60例,随机分为自控镇痛镇静（PCAS）组和静脉复合麻醉（TIVA）组,每组30例。PCAS组：接自控镇痛泵,负荷剂量设为0.05 m L/kg,继之以0.6 m L/（kg·h）的速度持续泵入丙泊酚与瑞芬太尼的混合药液,待负荷量输注完毕3 min后即可开始检查,术中患者根据自身感觉按压自控手柄,自控剂量为1 m L,锁定时间为1 min。TIVA组：静脉缓慢推注芬太尼1μg/kg,咪达唑仑0.02 mg/kg,2 min后缓慢推注丙泊酚0.8-1.0 mg/kg,待患者意识消失呼之不应即可开始检查。结果两组患者的平均血压在组内各时间点均较麻醉前下降,差异有统计学意义（P〈0.05）;TIVA组的平均血压下降比PCAS组更明显,差异有统计学意义（P〈0.05）。两组患者的心率、脉搏血氧饱和度及呼吸频率在组内各时间点均较麻醉前下降,差异有统计学意义（P〈0.05）;呼气末二氧化碳则较麻醉前升高,但组间比较差异均无统计学意义（P〉0.05）。两组患者的诱导时间、进镜至回盲部的时间以及总检查时间比较差异均无统计学意义（P〉0.05）,但从检查结束至OAA/S评分达5分和Aldrete评分达9分时间相比,PCAS组显著短于TIVA组,差异有统计学意义（P〈0.05）。结论瑞芬太尼与丙泊酚混合溶液用于PCAS较传统的静脉麻醉为老年患者提供更好的循环稳定性,麻醉恢复更迅速,可能成为老年患者肠镜检查的理想镇静镇痛方式。
文摘Objective To observe the analgesia effectiveness and safety of electroacupuncture at Neimadian （内麻点 Extra） after abdominal surgery. Methods One hundred and twenty patients with routine abdominal surgery were randomly divided into an acupuncture group and a medication group, 60 cases in each group. The acupuncture group was treated with electroacupuncture at Neimadian （内麻点 Extra）, which was located on the medial side of lower leg, 7 cun above the medial malleolus and about 0.5 cun from post edge of tibia. The medication group was treated with patient-controlled intravenous analgesia （PCIA） with Sufentanil. After the treatment, the Visual Analogue Scale （VAS）, the security, the analgesic effect and plasma β-endorphin content in the two groups were compared.Results The postoperative VAS scores at 2, 4, 8, 16, 24 and 48 h in the acupuncture group were lower than those in the medication group （all P〈0.05）. The analgesic effects at 2, 4, 16 and 24 h after surgery in the acupuncture group were superior to those in the medication group （P〈0.05, P〈0.01）. The plasma β-endorphin contents at 0, 8, 16 and 48 h after surgery in both groups were increased, and the acupuncture group was superior to the medication group （all P〈0.05）. The security class after surgery in the acupuncture group was higher than that in the medication group （P〈0.05）. Two cases in acupuncture group stopped treatment due to overstress and fear of needling, 24 cases in medication group presented adverse reactions, among them, 3 cases stopped the treatment due to nausea, vomiting. Conclusion The analgesic effect and safety of electroacupuncture at Neimadian （内麻点 Extra） after abdominal surgery are superior to those of the PCIA with Sufentanil.
