地佐辛对结肠癌根治术后罗哌卡因持续切口镇痛作用的影响  

Dezocine Improving Analgesic Efficacy of Continuous Wound Infusion of Ropivacaine for Abdominal Colorectal Surgery

作　　者：何焕钟[1] 徐恒艺[1] 王钱荣[1] 郑照正[2] 

机构地区：[1]浙江省湖州市中心医院麻醉科,湖州313000 [2]浙江省湖州市中心医院肛肠外科,湖州313000

出　　处：《中国中西医结合外科杂志》2013年第2期129-132,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:研究地佐辛对结肠癌根治术后罗哌卡因持续切口镇痛作用的影响。方法:将40例择期行结肠癌根治术的患者随机分为地佐辛复合罗哌卡因组(D组)和罗哌卡因组(R组),手术结束后,进行切口局部浸润并放置渗透导管,D组经切口持续给予0.2%罗哌卡因(内含地佐辛54μg/mL),R组给予0.2%罗哌卡因。结果:D组术后12h、24h和48h咳嗽和休息时VAS评分低于R组(P<0.05),R组48h内镇痛泵按压次数及舒芬太尼使用量明显高于D组(P<0.05),恶心呕吐及嗜睡发生率R组高于D组(P<0.05)。肠蠕动恢复时间及术后离床时间,D组早于R组(P<0.05)。两组患者术后切口愈合良好,无1例发生切口感染。结论:地佐辛增强罗哌卡因术后持续切口镇痛的效果,有利于患者的术后早期恢复。Objective To study the analgesic efficacy of continuous wound infusion of Ropivacaine with Dezocine for abdominal colorectal surgery. Methods A randomized, participant and outcome assessor-blind- ed, placebo-controlled trial was performed on 40 patients presenting for major abdominal colorectal surgery from June 2010 to May 2012. Patients were allocated to receive ropivacaine 0.2% in conjunction with Dezocine or Ropivacaine 0.2% via a dual catheter Painbuster Soaker continuous infusion device into their midline laparoto- my wound for 48 hours postoperatively. Results The continuous wound infusion of ropivacaine in conjunction with Dezocine after abdominal colorectal surgery conveys greater benefit compared with sole Ropivacaine wound infusion, statistically significant differences could be shown for： VAS scale, morphine usage, mobility, nausea, or recovery time of bowel function. Conclusion Management of pain after major abdominal colorectal surgery is best achieved through adopting a continuous wound infusion of Ropivacaine in conjunction with Dezocine.

关 键 词：结肠根治术 持续切口镇痛 地佐辛 外周阿片受体 

分 类 号：R971.3[医药卫生—药品]