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硬膜外腔注入混合液用于术后镇痛的效果与安全性观察

时间:2017-09-09 07:00:10来源:www.xielunwen.net 作者:admin 点击: 13 次
作者:孙富德,王海霞,吕志凯,高杰 【关键词】硬膜外腔;术后镇痛;咪唑安定;曲马多;布比卡因 [摘要]目的:观察硬膜外腔注入咪唑安定、曲马多、布比卡因混合液用于病人术后镇痛的效果与安全性。方法:选择60例妇科肿瘤病人,年龄20岁~58岁,随机分为A、B两组,每组30例,行T12~L1硬膜外腔推入0.5%布比卡因3ml+曲马多100mg(A组),0.5%布比卡因3ml+曲马多100mg+

                              作者:孙富德,王海霞,吕志凯,高杰

【关键词】  硬膜外腔;术后镇痛;咪唑安定;曲马多;布比卡因

  [摘  要] 目的:观察硬膜外腔注入咪唑安定、曲马多、布比卡因混合液用于病人术后镇痛的效果与安全性。方法:选择60例妇科肿瘤病人,年龄20岁~58岁,随机分为A、B两组,每组30例,行T12~L1硬膜外腔推入0.5%布比卡因3 ml+曲马多100 mg(A组),0.5%布比卡因3 ml+曲马多100 mg+咪唑安定2 mg(B组),两组均用0.9%氯化钠注射液稀释为10 mg,行术后镇痛治疗。结果:两组镇痛有效率和持续时间相比有明显差异(P<0.05),B组镇痛0分级例数明显高于A组(P<0.05),提示B组镇痛高于A组,两组间恶心呕吐的副作用相比差异有显著性(P<0.05),其他副作用相比无统计学意义(P>0.05)。结论:术后经硬膜外腔推入咪唑安定、曲马多、布比卡因混合液用于病人术后镇痛效果确切,不良反应少,病人满意,值得推广。

  [关键词] 硬膜外腔;术后镇痛;咪唑安定;曲马多;布比卡因

  Observe the Efficacy and Safety of Postoperative Pain Recief with Epidural Infusion Tumors

  Abstract:Objective Searching ror the efficacy and safety of epidural midazolam tramadol bupivacaine as tumours patient of gynaecology for postoperative analgesia via epiaural infusion.Methods 60 patients of tumours patient If gynaecoloty were randomly assigned to two groups(n=30).aged 20 y~58 y,competent T12~L1 puncture cpidural,It is put and in charge of that the head towards,postoperative analgesia viv epidural infusion with 0.5% bupivacaine 3 ml+tramadol 100 mg(A group),0.5% bupivacaive 3 ml+tramadol 100 mg+midazolam 2 mg(B group),two groups dilute with 0.9%NS for 10 ml.Results Two groups of result dase pain there are obvius differences efficiently compared with duration (P<0.05),group ease pain 0 hierarchical example count and higher than Agroup obviously(P<0.05).Brief on B group tk eade pain intensity higher than A guoup.The disgusting side effect that vomits compares remarkable differencebetween two groups (P<0.05),it does not have xtatistical meaning that other side effects are compared(P<0.05),Conclusion The effect of postoperstive analgesia is exactly after push midazolam、tramadol、bupivaceine via epidural infusion. there are little bad reactions,The patient is satisfied,deserve to popularize.

  Key words:Epidural;Postoperative pain recief; Midazolam;Tramadol;Bupivacaine
   
  为缓解或消除术后病人的疼痛刺激,笔者对60例施行硬膜外麻醉的妇科病人采取术后硬膜外腔注射咪唑安定、曲马多、布比卡因混合液的方法行术后镇痛。现总结如下。

  1  资料与方法

  1.1  一般资料 

  选择60例妇科肿瘤病人,ASA Ⅰ~Ⅱ级。年龄20岁~58岁,体重42 kg~78 kg,随机分为布比卡因+曲马多组(A组)30例,布比卡因+曲马多+咪唑安定组(B组)30例。

  1.2  麻醉方法 

  病人入室待平静后行硬膜外腔穿刺,穿刺间隙全部为T12~L1,头向置管。术中间断推注2%利多卡因维持麻醉,硬膜外麻醉效果完善,辅助用药均为杜啡合剂,剂量2 ml~3 ml。术后常规监测血压、心率、脉搏、血氧饱合度并吸氧。

  1.3  硬膜外镇痛方法 

  手术即将结束时,两组病人分别由硬膜外导管单次注入;A组0.5%布比卡因3 ml+曲马多100 mg,B组咪唑安定2 mg+曲马多100 mg+0.5%布比卡因3 ml,两组均用生理盐水稀释为10 ml,时间控制在1 min内注射完,观察病人15 min,无异常情况后拔管,返回病房。

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