地佐辛静脉用药对剖宫产产妇术后宫缩痛的影响  

Effect of postoperative intravenous analgegia using dezocine on uterine contraction-induced pain after cesarean section

作　　者：朱爱兵[1] 沈明坤[1] 徐志勇[1] 

机构地区：[1]南京医科大学附属无锡市妇幼保健院麻醉科,214002

出　　处：《中国综合临床》2011年第11期1207-1209,共3页Clinical Medicine of China

摘　　要：目的观察地佐辛静脉用药对剖宫产产妇术后宫缩痛的影响。方法60例剖宫产手术产妇随机均分为2组：D组术后采用地佐辛联合曲马多静脉自控镇痛；T组采用曲马多静脉自控镇痛。2组术毕前10min给予负荷量，D组静脉注射地佐辛0．1mg／kg；T组静脉注射曲马多2mg／kg。观察术后4、8、16、24h的创口痛和宫缩痛的VAS评分和不良反应发生情况。结果2组产妇创口痛VAS评分无统计学意义（P〉0．05），术后4、8、16、24h宫缩痛的VAS评分D组[分别为（1．53±0．37）、（2．28±O．15）、（2．43±0．56）、（2．01±0．64）分]明显低于T组[分别为（4．73±0．43）、（5．86±0．35）、（5．83±0．27）、（4．18±0．53）分，P均〈0．01]，术后4、8 h Ramsay镇静评分D组[（分别为（3．97±1．41）、（3．12±0．06）分]高于T组[分别为（1．12±0．49）、（1．09±0．73）分，P均〈0．01]。2组术后不良反应发生情况相仿（P〉0．05）。结论剖宫产手术采用地佐辛复合曲马多静脉自控镇痛对产妇的创口痛和宫缩痛均能达到良好的镇痛，且不良反应少。Objective To study the effect of postoperative patient-controlled intravenous analgegiausing dezocine on uterine contraction-induced pain after cesarean section. Methods Sixty patients undergoing cesarean section were randomly divided into two groups with 30 cases each. Group D received patient-controlled intravenous analgesia （PCIA） with dezocine and tramadol. Group T received PCIA with tramadol. Ten minutes before completion of the operation, loading dose was given ： in group D intravenous dezocine 0. 1 mg/kg, in group T intravenous tramadol 2 mg/kg. Visual analogue scale （VAS） of wound pain and uterine contraction-induced pain,adverse effects were recorded at 4,8,16 and 24 h during analgesia. Results There was no signiciant difference on VAS of wound pain between the two groups （ P 〉 0. 05 ）. The VASs of uterine contraction-induced pain at the 4,8,6 and 24th hour after surgery were （ 1.53 ± 0. 37 ）, （ 2. 28 ± 0. 15 ）, （ 2. 43±0. 56 ） and （2. 01 ±0. 64） respectively in Group D, which were significantly lower than those of （4. 73 ＋ 0. 43 ）, （ 5.86 ±0. 35）, （5. 83 ± 0. 27） and （4. 18 ± 0. 53 ） in Group T （Ps 〈 0. 05 ）. Ramsay sedation scores were （ 3.97 ± 1.41 ） and （3. 12 ± 0. 06） at the 4 and 8 h, which were significantly lower than those of （ 1.12 ± 0. 49） and （ 1.09 ±0. 73） in Group D（Ps 〈0. 01 ） ）. However,there was no significant difference between the two groups in adverse effect （ P 〉 0. 05 ）. Conclusion Intravenous patient-controlled analgesia with dezocine composite tramadol is not only effective for wound pain scores,but also can suppress uterine contraction-induced pain with less adverse effect in patients underwent cesarean section.

关 键 词：地佐辛 宫缩痛 剖宫产术 曲马多 自控静脉镇痛 

分 类 号：R614[医药卫生—麻醉学]