镇痛泵的使用和管理1

舒芬太尼0.01mg推荐常用配方见表药物(浓度)负荷剂量bolus剂量锁定时间持续输注芬太尼(10ug/ml)10-30ug10-30ug10-15min0-10ug/h舒芬太尼(1-2ug/ml)1-3ug2-4ug10-15min1-2ug/h曲马多10mg/ml2-3mg/kg20-30mg10-15min1-15mg/h2.PCEAPCEA药物Concentration浓度Rate(ml/h)持续输注Bolus剂量(ml)Lockouttime(min)锁定时间1hLimit(ml)Ropivacaine0.1~0.12%2~821510Bupivacaine0.1~0.12%2~821510Fentanyl*1~2ug/ml2~821510Morphine*20ug/ml2~821510Sufentanyl*0.1-0.2ug/ml2~8215103、注射用NSAIDs药物———————————————————————————————————————注射液剂量范围起效时间维持时间用法和用量(mg)(min)(h)———————————————————————————————————————氟比洛芬酯(凯芬)50-200158IV:50mg/次,3-4次/日或50mg首剂,100-150mg/d附:镇痛泵配方原则根据三阶梯镇痛模式制定镇痛方案一阶梯:疼痛评估二阶梯:I.疼痛评分<=3分即轻度疼痛,配方以NSAIDS类药物如氯诺昔康等为主;II.疼痛评分4-6分即中度疼痛,PCIA配方以弱阿片类药物如曲马多等为主和或配伍NSAIDS类药物;PCEA配方以罗哌卡因+芬太尼/吗啡;III.疼痛评分>=7分即重度疼痛,应用强阿片类药物如:芬太尼、舒芬太尼等为主和或配伍NSAIDS类药物;三阶梯:反复评估,及时按阶梯调整用药、剂量及给药方式,确定患者保持无痛状态,提高生活质量