芬太尼联合右美托咪定在重症急性胰腺炎的镇痛镇静效果研究
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- 英文论文题名：Effect observation of dexmedetomidine combined with fentanyl on analgesia in patients with severe acute panreatitis
- 论文作者：何娟 ; 杨婉花
- 英文论文作者：He Juan ; YANG Wan-Hua ; Department of Pharmacy of Ruijin Hospital Affiliated to Shanghai JiaoTong University School of Medicine
- 年：2016
- 作者机构：上海交通大学医学院附属瑞金医院药剂科;
- 论文关键词：右美托咪定 ; 芬太尼 ; 重症急性胰腺炎 ; 镇痛
- 英文论文关键词：Dexmedetomidine ; fentanyl ; severe acute panreatitis ; analgesia
- 会议召开时间：2016-09-27
- 会议录名称：中国药学会第十三届青年药学科研成果交流会论文集
- 语种：中文
- 分类号：R576
- 学会代码：YYWS
- 会议名称：中国药学会第十三届青年药学科研成果交流会
- 会议地点：中国江西南昌
- 主办单位：中国药学会
- 学会名称：中国药学会
- 页数：4
- 文件大小：267k
- 原文格式：O
- 会议级别：全国
摘要
目的:评估芬太尼联合右美托咪定在重症急性胰腺炎患者的镇痛镇静治疗中的有效性、安全性和耐受性。方法:采用回顾性研究方法,通过对我院急诊ICU就诊的SAP患者进行调查,在常规心电监测、禁食、胃肠减压、抑酸抑酶等综合治疗的基础上,对其中剧烈腹痛者单独使用芬太尼(芬太尼组)或芬太尼联合右美托咪定(联合用药组),记录两组患者的信息,比较两种方案治疗前后的心率、呼吸等参数变化。采用疼痛VAS评分评价用药后不同时段疼痛程度。记录不良反应发生率。结果:两组患者用药后各时点疼痛VAS评分均<2.5分,芬太尼组用药后各时段疼痛VAS评分显著高于联合用药组(P<0.05),且恶心呕吐发生率也较高(P<0.05)。结论:芬太尼联合右美托咪定可显著提高SAP镇痛镇静效果,同时降低芬太尼不良反应,具有良好的临床应用前景。
Objective To observe the effect of dexmedetomidine combined with fentanyl on analgesia in patients with severe acute panreatitis.Method Patients with severe acute panreatitis were divided into two groups:fentanyl group and combination group(dexmedetomidine combined with fentanyl),Pain intensity was assessed with visual analog scale(VAS)before and after medication at different time points.The incidence of side effects were recorded.Result VAS scores of the two groups at different time points were less than 2.5 scores(P<0.05).The incidence of nausea and vomiting in fentanyl group was higher than those of combination group(P<0.05).Conclusion Dexmedetomidine combined with low dose fentanyl can improve the effect of analgesia in patients with severe acute panreatitis,and decrease the incidence of nausea and vomiting.
Objective To observe the effect of dexmedetomidine combined with fentanyl on analgesia in patients with severe acute panreatitis.Method Patients with severe acute panreatitis were divided into two groups:fentanyl group and combination group(dexmedetomidine combined with fentanyl),Pain intensity was assessed with visual analog scale(VAS)before and after medication at different time points.The incidence of side effects were recorded.Result VAS scores of the two groups at different time points were less than 2.5 scores(P<0.05).The incidence of nausea and vomiting in fentanyl group was higher than those of combination group(P<0.05).Conclusion Dexmedetomidine combined with low dose fentanyl can improve the effect of analgesia in patients with severe acute panreatitis,and decrease the incidence of nausea and vomiting.
引文
[1]中华医学会外科学会胰腺外科学组.重症急性胰腺炎诊治草案[J].中国实用外科杂志,2001,21(9):513-514.
[2]Mantz Jean,Josserand Mien,Hamada Sophie.Dexmedetomidine:new insights.2011 European Society of Anaesthesiology
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[4]HONEYB L,BENEFIELDR J,MILLER J L,et al.Alpha2-receptor agonists for treatment and prevention of iatrogenic opioid abstinence syndrome in critically ill patients[J].Ann Pharmacother,2009,43(9):1506-1511.
[5]Mohta M,Kumari N,Tyagi A,et al.Tramadol for prevention of postanaesthetic shivering:a randomised double-blind comparison with pethidine.Anaesthesia.2009 Feb;64(2):141-6.
[6]黄青青.右美托咪啶在重症监护病房中的应用.中国危重病急救医学,2010,22(10):578-580.
[7]Jacobi J.Fraser GL,Coursin DB,et al.Clinical practice guidelines for the sustained use ofsedatives and analgesics in the critically ill adult.Grit Care Med,2002,30(1):119-141.
[8]Venn RM,Bradshaw CJ,Spencer R,et al.Preliminary UK experience of dexmedetomidine,a novel agent for postoperative sedation in the intensive care unit[J].Anaesthesia,1999,54(12):1136.
[9]王京.右美托咪定辅助舒芬太尼超前镇痛用于胆囊术患者术后镇痛效果观察.湖北民族学院学报·医学版,2011,28(3):30-32.
[10]Yildiz M,Tavlan A,Tunur s,et al.Efect of dexmedetonidine on haemodynamic responses to laryngoscopy and in tubation:perioperative haemodynamics and anaesthetic requirements[J].Drugs RD,2006,7:43-52.
[11]LIN T F,YEH Y C,LIN F S,et al.Efect of combining dexmedetomidine and morphine for intravenous patient-controlled analgesia[J].Br J Anaesth,2009,102(1):117-122.
[12]邬子林,周志飞,许立新等.右旋美托咪啶对老年患者全髋置换术后芬太尼静脉自控镇痛效果的影响[J].南方医科大学学报,2011,31(4):701-704.
[2]Mantz Jean,Josserand Mien,Hamada Sophie.Dexmedetomidine:new insights.2011 European Society of Anaesthesiology
[3]Bhana N,Goa KL,McClellan K.Dexmedetomidine[J].Drugs,2oo0.59:263-268
[4]HONEYB L,BENEFIELDR J,MILLER J L,et al.Alpha2-receptor agonists for treatment and prevention of iatrogenic opioid abstinence syndrome in critically ill patients[J].Ann Pharmacother,2009,43(9):1506-1511.
[5]Mohta M,Kumari N,Tyagi A,et al.Tramadol for prevention of postanaesthetic shivering:a randomised double-blind comparison with pethidine.Anaesthesia.2009 Feb;64(2):141-6.
[6]黄青青.右美托咪啶在重症监护病房中的应用.中国危重病急救医学,2010,22(10):578-580.
[7]Jacobi J.Fraser GL,Coursin DB,et al.Clinical practice guidelines for the sustained use ofsedatives and analgesics in the critically ill adult.Grit Care Med,2002,30(1):119-141.
[8]Venn RM,Bradshaw CJ,Spencer R,et al.Preliminary UK experience of dexmedetomidine,a novel agent for postoperative sedation in the intensive care unit[J].Anaesthesia,1999,54(12):1136.
[9]王京.右美托咪定辅助舒芬太尼超前镇痛用于胆囊术患者术后镇痛效果观察.湖北民族学院学报·医学版,2011,28(3):30-32.
[10]Yildiz M,Tavlan A,Tunur s,et al.Efect of dexmedetonidine on haemodynamic responses to laryngoscopy and in tubation:perioperative haemodynamics and anaesthetic requirements[J].Drugs RD,2006,7:43-52.
[11]LIN T F,YEH Y C,LIN F S,et al.Efect of combining dexmedetomidine and morphine for intravenous patient-controlled analgesia[J].Br J Anaesth,2009,102(1):117-122.
[12]邬子林,周志飞,许立新等.右旋美托咪啶对老年患者全髋置换术后芬太尼静脉自控镇痛效果的影响[J].南方医科大学学报,2011,31(4):701-704.