地佐辛超前镇痛在膝关节镜手术中的应用  

Application of Using Dezocine Preemptive Analgesia in Knee Arthroscopic Operation

作　　者：李捷萌[1] 蔡洪[1] 邱琼喜[1] 

机构地区：[1]福建省泉州市中医院麻醉科,福建泉州362000

出　　处：《黑龙江医学》2013年第11期1062-1063,共2页Heilongjiang Medical Journal

摘　　要：目的评价地佐辛超前镇痛用于膝关节镜手术的临床效果及不良反应。方法 60例硬膜外麻醉下行膝关节镜手术患者,随机分为超前镇痛组(A组)和术后镇痛组(B组),每组30例。L3-4间隙穿刺,置管行连续硬膜外麻醉,控制麻醉平面在T10以下。A组在硬膜外麻醉成功后,术前15 min缓慢静脉注射地佐辛0.1 mg/kg。B组则在术后关闭关节镜时缓慢静脉注射地佐辛0.1 mg/kg。观察记录患者术前、术中、术后4 h、8 h血压,并于术后2 h、4 h、8 h、24 h对患者的疼痛程度,采用VAS评分法进行评价;记录患者术后24 h内其他镇痛药使用率和恶心呕吐发生率。结果术后2 h、4 h、8 h、24 h疼痛评分,A组明显低于B组,两组相比有统计学意义(P<0.05)。A组手术前、手术中、手术后4 h、8 h收缩压、舒张压差异均无统计学意义;B组手术后4 h、8 h收缩压、舒张压无变化,但与手术前、手术中相比显著增高;术后4 h、8 h,B组收缩压明显高于A组。舒张压两组差异无统计学意义。术后24 h内,A/B组镇痛药使用情况:3(10.0%)/4(13.3%)和恶心呕吐4(13.3%)/3(10.0%),差异均无统计学意义。结论地佐辛有超前镇痛作用,能够减轻膝关节镜手术患者术后的疼痛,并使术后患者的生命体征平稳,有利于患者的康复。Objective To observe the effect and side effect of dezocine treatment in knee arthroscopic operation. Methods 60 cases of knee arthroscopic operation patients with ASA statusⅠ~Ⅱafter Epidural anesthesia were studied. They were randomly divided into preemptive analgesia group( group A) and postoperative analgesia group( group B),with 30 cases in each group. L3-4 gap puncture and tube continuous epidural anesthesia were controlled to the level of anesthesia in T10. Group A after epidural anesthesia,15min before the start of the operation was slowly injected with dezocine 0. 1mg / kg. Group B at the end of the operation was slowly injected with dezocine 0. 1mg / kg.Patients' blood pressures before operation,during operation,4 and 8h after operation were observed and recorded,and the pain degree of patients was evaluated by VAS score method 2,4,8,24h after operation. Other analgesic usage of patients and incidence of nausea and vomiting within postoperative 24h after operation were recorded. Results The pain score of 2,4,8,24h after operation in group A was significantly lower than that in group B. There was statistical significance( P < 0. 05). The difference of systolic pressure and diastolic pressure in group A before operation,during operation,4 and 8h after operation was not statistically significant. The systolic pressure and diastolic pressure in group B 4 and 8h after operation did not change,but significantly increased compared with before operation and during operation. Through comparing the two groups of systolic pressure 4 and 8h after operation,group B was significantly higher than that in group A. Diastolic pressure had no significant difference between two groups. Analgesic use ratio of group A / B in postoperative 24h: 3( 10. 0%) /4( 13. 3%) and nausea and vomiting 4( 13. 3%) /3( 10. 0%) there were no significant differences between the two groups. Conclusion The effect of preemptive analgesia with dezocine can reduce the patients pain after knee arthroscopic operation,providing the postoperative

关 键 词：地佐辛 关节镜 镇痛 

分 类 号：R614[医药卫生—麻醉学]