国际麻醉学与复苏杂志   2010, Issue (2): 127-130
    
无线镇痛泵系统临床应用效果观察
曹汉忠 刘存明 鲍红光 丁正年 张建锋 金小洁1()
1.226361,江苏省南通市肿瘤医院麻醉科(曹汉忠,张建锋,金小洁);南京医科大学第一附属医院麻醉科(刘存明、丁正年);南京市第一医院麻醉科(鲍红光)
The effects of clinical application of the wireless analgesic pump and its management system
 全文:
摘要:

目的 评价无线镇痛泵系统是否具有预期的安全性和有效性。方法 术后需自控镇痛患者(ASAI-II)144例,纯随机分为2组,试验组72例,采用无线镇痛泵系统;对照组72例,采用ZZB全自动注药泵。 在手术结束后,以首次量+持续给药+自控给药行静脉自控镇痛(PCIA)48 h。镇痛药物配方:芬太尼12 ug•kg-1•d-1 +氟哌利多5 mg+生理盐水至150 ml。参数设定:首次量5 ml、持续量2.5 ml/h,单次量3ml/次,锁定时间8 min。观察指标:① 患者年龄、性别、体重及术前体温、心率、呼吸、血压。② 应用评分数字疼痛评分法(NRS),分别于PCIA后4、24和48 h评价患者的疼痛程度;③ 患者按压自控镇痛键的总次数;④ 患者按压自控镇痛键的有效次数;⑤ 安全性指标:观察患者在使用后早期(4 h内)有无寒战、发热、恶心、呕吐、呼吸抑制等不良症状及其他不良事件。结果 胸外科、泌尿科、骨科及普外科手术患者共144例(其中试验组72例,对照组72例),2组患者年龄、性别、体重及使前T、Hr、R、BP等指标的比较差异均无统计学意义(P>0.05)。试验组PCIA后4、24及48 h患者的疼痛评分(NRS)分别为1.35±1.41,1.64±1.50,1.36±1.36;对照组PCIA后4 h及48 h患者的疼痛评分(NRS)分别为1.36±1.28,2.10±1.84,1.71±1.73,2组间比较差异无统计学意义(P>0.05)。患者按压自控镇痛键的总次数试验组6.08±9.77,对照组5.07±12.63,有效次数试验组为2.93±3.60,对照组3.25±5.93,2组间差异无统计学意义(P>0.05)。患者在使用后早期(4 h内)无寒战、发热、恶心、呕吐、呼吸抑制等不良症状及其他不良事件。结论:无线镇痛泵系统能安全地用于各种急慢性疼痛个体化治疗及其他需持续或间断给药,以维持一定的血药浓度的疾病治疗。

关键词: 镇痛泵; 无线;患者自控镇痛;镇痛管理
Abstract:

Objective To assess and safety and efficacy of the wireless analgesic pump system. Methods 144 patients (ASAI-II), received postoperative patient-controlled vein analgesia(PCIA)for 48 h, were randomly divided into two groups: the test group(n=72), using the wireless analgesic pumps system,and the control group(n=72), using type ZZB analgesic pump.The settings were as follows:loading does 5 ml,background infusion 2.5 ml/h, bolus 3ml, lockout time 8 min,and the prescription were as follows:fentanyl 12 μg•kg-1•d-1,droperidol 5 mg Admixed with NS to reach 150 ml. Outcome measures: ① Age, weight, sex, and preoperative T, Hr, RR, BP. ②pain rating when using PCIA for 4h, 24h, 48h. ③ the number of all attempts. ④the number of successfully delivery. ⑤shivering, fever, nausea, vomiting, respiratory depression and other adverse adverse effect in early phase. Results 144 patients underwent thoracic,urology, orthopedics, and general surgery. NO differences in age, weight, sex, and preoperative T, Hr, RR, BP were found between two groups (P>0.05). The pain rating NRS are 1.3±1.4, 1.6±1.5 and 1.3±1.4 in test group and 1.3±1.3, 2.1±1.8 and 1.7±1.7 in control group at 4,14,48 h.. There were no difference between two groups (P>0.05). The number of all attempts is 6±10 in test group and 5±13 in control group, the number of successfully delivery is 2±4 in test group and 3±6 in control group during 48 h, which were no difference between two groups (P>0.05). Patients did not have any adverse effcet in early phase. Conclusion The wireless analgesic pump and its management system were safe for individual treating a variety of acute or chronic pain and other treatment requiring continuing or intermittent injection to maintain a certain plasma concentration.

Key words: Analgesic pump; Wireless; Patient-controled analgesia; Analgesic management