Ohtsuka Mikiko
Department of Anesthesia, Takeda Hospital, Kyoto 600-8558.
Masui. 2006 Apr;55(4):428-30.
Pentazocine is one of the most popular analgesics for postoperative analgesia in Japan. For patient-controlled analgesia (PCA), however, opioid agonists are used commonly, and little information is available concerning PCA by pentazocine. We studied the effects of postoperative PCA using intravenous pentazocine.
Eighteen male patients who had undergone open reduction and internal fixation of fructure of extremities under general anesthesia received intravenous pentazocine via PCA. The procedure of PCA was as follows; continuous infusion set 1.5-2.5 mg x h(-1), size of bolus set 5-10 mg with 10-15 minutes lockout interval. We added droperidol for prevention of nausea and vomiting.
Eleven patients (61.1%) recovered without using any other analgesics. However, seven patients needed other treatments. Six patients used suppository of diclofenac and the other one received pentazocine intramuscularly besides diclofenac. Four of seven patients received these additional analgesics without PCA bolus. No significant complications were observed except nausea in three patients, drowsiness in two and somnolence in one.
Our program of PCA was safe and effective for postoperative analgesia. But the guidance for patients, surgeons and nursing staff is important using PCA therapy more effectively.
喷他佐辛是日本术后镇痛最常用的镇痛药之一。然而，对于患者自控镇痛（PCA），通常使用阿片类激动剂，关于喷他佐辛用于PCA的信息很少。我们研究了静脉注射喷他佐辛用于术后PCA的效果。
18例在全身麻醉下接受四肢骨折切开复位内固定术的男性患者通过PCA接受静脉注射喷他佐辛。PCA的程序如下：持续输注设置为1.5 - 2.5毫克×小时⁻¹，单次剂量设置为5 - 10毫克，锁定间隔为10 - 15分钟。我们添加氟哌利多以预防恶心和呕吐。
11例患者（61.1%）未使用任何其他镇痛药而康复。然而，7例患者需要其他治疗。6例患者使用双氯芬酸栓剂，另1例除双氯芬酸外还接受了喷他佐辛肌内注射。7例患者中有4例在未使用PCA单次剂量的情况下接受了这些额外的镇痛药。除3例患者出现恶心、2例嗜睡和1例昏睡外，未观察到明显并发症。
我们的PCA方案对术后镇痛安全有效。但对患者、外科医生和护理人员进行指导对于更有效地使用PCA治疗很重要。
