地佐辛增强布比卡因硬膜外患者自控镇痛的效果  

Efficacy of dezocine in enhancing postoperative patient-controlled epidural analgesia with bupivacaine

作　　者：赵保建[1,2] 刘功俭[1] 王红军[1] 齐敦益[1] 申文[1] 曹俊平[1] 孟晶[1] 丁月东[2] 

机构地区：[1]徐州医学院麻醉学院,江苏省221000 [2]连云港市第二人民医院新浦院区麻醉科

出　　处：《江苏医药》2013年第1期76-78,共3页Jiangsu Medical Journal

摘　　要：目的观察地佐辛用于增强患者术后镇痛的效果。方法经腹子宫全切术的患者60例,随机均分为基本资料相仿的三组,采用腰-硬联合麻醉,术后行0.125%布比卡因硬膜外患者自控镇痛(PCEA)。Ⅰ组术前静注地佐辛0.15mg/kg;Ⅱ组术毕将地佐辛0.15mg/kg加入0.125%布比卡因镇痛药液中;Ⅲ组不用地佐辛。记录术后3h(T1)、6h(T2)、12h(T3)、24h(T4)、48h(T5)VAS疼痛评分、BCS舒适度评级和Ramsay镇静评分。结果三组术后镇痛效果均良好,术后48h的VAS均<3分。Ⅰ、Ⅱ两组的VAS评分均低于Ⅲ组(P<0.05),且Ⅰ组低于Ⅱ组(P<0.05);Ⅰ、Ⅱ两组的BCS评级和Ramsay镇静评分均高于Ⅲ组(P<0.05),且Ⅰ组高于Ⅱ组(P<0.05);Ⅰ、Ⅱ组的自控按压次数明显少于Ⅲ组(P<0.05)。结论地佐辛能明显增强子宫全切术患者布比卡因PCEA作用,改善术后舒适度,有良好镇静效果;术前应用地佐辛效果更好。Objective To observe the efficacy of dezocine in enhancing postoperative patient- controlled epidural analgesia（PCEA） with bupivacaine. Methods Sixty patients undergoing abdominal hysterectomy were given postoperative PCEA with 0. 125% bupivacaine and equally randomized into three groups of Ⅰ （intravenous injection of dezocine 0. 15 mg/kg before operation）, II （adding dezocine 0. 15 mg/kg into 0. 125% bupivacaine analgesic solution） and Ⅲ （without dezocine as the control）. The VAS pain score, BCS grade and Ramsay sedation score were recorded at 3,6,12,24 and 48 h after surgery. Results The efficacy of postoperative analgesia of three groups was all satisfactory with VAS〈3 points. VAS scores were lower in groups of Ⅰ and Ⅱ than those in group Ⅲ （P〈0. 05）, which were lower in group Ⅰ than those in group Ⅱ （P〈0. 05）. BCS grade and Ramsay score were higher in groups of Ⅰ and Ⅲ than those in group Ⅲ （P〈0. 05） ,which were higher in group Ⅰ than those in group Ⅱ （P〈0. 05）. The numbers of PCA compression were less in groups of Ⅰ and Ⅱ than those in group Ⅲ （P〈0. 05 ）. No serious adverse responses occurred during 48-h postoperative analgesia in all three groups. Conclusion Dezocine is effective in enhancing postoperative PCEA with 0. 125% bupivacaine and improving postoperative comfortability and sedation in the patients underwent abdominal hysterectomy.

关 键 词：地佐辛 硬膜外自控镇痛 

分 类 号：R614[医药卫生—麻醉学]