兰州大学机构库 >学院待认领
不同配方的术后静脉镇痛泵镇痛镇静效果及对术后认知功能影响的研究
Alternative TitleResearch on postoperative PCIA effect and Early postoperative cognitive function recovery influence of using dezocine combined with fentanil, or with sufentanil after radical operation for carcinoma of stomach
高延
Thesis Advisor冷玉芳
2014-05-26
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword地佐辛 芬太尼 舒芬太尼 术后镇痛 认知功能
Abstract目的:研究不同配方的静脉镇痛泵用于胃癌根治术后PCIA的镇痛、镇静效果及对术后认知功能的影响。 方法:选择ASAⅠ~Ⅱ级,择期行胃癌根治术患者80例随机分为DF、DS、F、S四组,每组20例。DF组:地佐辛0.3mg/kg+芬太尼0.015mg/kg。DS组:地佐辛0.3mg/kg+舒芬太尼1.5ug/kg。F组:芬太尼0.03mg/kg。S组:舒芬太尼2ug/kg,四组均加生理盐水至100ml+昂丹司琼4mg。 PCIA背景剂量为2ml/h,自控给药5ml/次,锁定时间15min。观察并记录四组患者术后2h、4h、6h、8h、12h、24h、48h的VAS、Ramsay评分和不良反应发生率、总体满意度。分别于术前1d和术后3h、12h、24h、48h对患者进行MMSE评分。 结果:与DS组、S组比较,F组、DF组在术后各时间点的VAS、MMSE评分均明显升高(P<0.01)。与其它三组比较S组在各时间点Ramsay评分及不良反应发生率最高(P<0.O5),DS组总体满意度最高(P<0.05)。 结论:地佐辛0.3mg/kg+舒芬太尼1.5ug/kg+昂丹司琼4mg+生理盐水至100ml应用于胃癌根治术患者术后PCIA,镇痛效果优良,镇静效果满意对患者术后早期认知功能影响较小,不良反应发生率低,安全性高。 关键词:地佐辛,芬太尼,舒芬太尼,术后镇痛,认知功能
Other AbstractObjective:To observe the postoperative PCIA effect and Early postoperative cognitive function recovery influence of using dezocine combined with fentanil, or with sufentanil, or only fentanil or sufentanil in patients underwent radical operation for carcinoma of stomach. Methods:80 stomach cancer patients who are in ASA I~II level aged 30--60ys; weighted 40~85kg; with health body mass index; no medical history on hypertension/ psychosis /neuropathy; no long-term sedative medicine taking; no alcoholism /drug dependency and no severe dysopia/auditory handicap) were randomly divided into 4 groups: groupDF/DS/F/S, 20 in each group. All patients were given general anesthetic, infused with 10ml PCIA analgesics 30mins before operation ends up, and were connected the analgesic pump after anesthesia awake.PCIA gradients:group DF:dezocine 0.3mg/kg+fentanil0.015mg/kg+ Ondansetron 4mg +0.9% sodium chloride injection to 100ml .group DS: dezocine 0.3mg/kg+sufentanil 1.5ug/kg + Ondansetron 4mg+0.9% sodium chloride injection to 100ml .Group F: fentanil 0.03mg/kg +Ondansetron 4mg+0.9% sodium chloride injection to 100ml .Group S:sufentanil 2ug/kg+ Ondansetron 4mg+0.9% sodium chloride injection to 100ml .2ml/h PCIA background dose and 15mins lock time for above gradients. Then observe and check VAS scores; Ramsay scores; adverse reactions and satisfaction degree in quiet of 2, 4, 6, 8, 12, 24, 48 hours after operation. We also take the MMSE assessment of patients at 1d before operation and 3h, 12h, 24h, 24h after operation. Results:The results are unrelated with 4 groups’ samples; age; height; weight and operation times.Group DS and S provided good analgesic effect. The VAS scores at all time spots are no difference between group F and group DF(P>0.05). There is also no difference between group DS and group S(P>0.05). The VAS scores at respective time spots after operation are significantly higher than group S and group DS (P=0.002). None of the groups showed Excessive sedation after postoperative PCIA. The Ramsay scores on respective time spots have no difference for group DF and group D(P>0.05). No difference about 2h、4h、12h、48h post operation data between group S and group DS(P>0、05),but group S has obvious difference with others in 6h,8h post operation data (P<0.05), group DF and group F have statistical difference with group DS and group S in 2h、4h、6h、8h post operation data(P<0.05), there are no differences at time spots of 12h、2...
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Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/223783
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
高延. 不同配方的术后静脉镇痛泵镇痛镇静效果及对术后认知功能影响的研究[D]. 兰州. 兰州大学,2014.
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