地佐辛、吗啡、纳布啡对于门诊患者术后镇痛效果的比较  

Serial intravenous doses of dezocine,morphine and nalbuphine in the management of postoperative pain for outpatients

作　　者：黎环[1] 

机构地区：[1]青海省人民医院麻醉科,青海西宁810007

出　　处：《中国医院药学杂志》2013年第12期978-981,共4页Chinese Journal of Hospital Pharmacy

摘　　要：目的:对地佐辛、吗啡、纳布啡的门诊术后镇痛效果进行比较。方法:对象为在全身麻醉下进行关节镜手术的成人患者,方法为双盲对照研究试验,患者随机分成4组,术后分别接受不同止痛药物的静脉注射剂,其中包括地佐辛(20例)、吗啡(22例)、纳布啡(18例)和生理盐水(24例)的4个治疗组。注射间隔为10 min,共注射4次,每次0.5 mL(含药物5 mg)。当药物不能达到临床止痛效果时,患者可选择其他止痛剂。如果初始治疗应用的是地佐辛或纳布啡,则应用1～4个剂量的吗啡作为备选治疗,如果初始治疗应用的是生理盐水或吗啡,则用1～4个剂量的地佐辛作为备选治疗。结果:初始治疗成功的患者的比例为:生理盐水组25%,纳布啡组33%(P=0.48),吗啡组54%(P=0.026),以及地佐辛组75%(P=0.003),地佐辛分别与吗啡和纳布啡相比,有显著差别(P=0.043和P=0.037)。结论:在术后止痛治疗方面,地佐辛比吗啡比和纳布啡的疗效更加显著。在本试验中,作为备选止痛剂,地佐辛需要较少的剂量就能够满足患者的止痛需求,并且比吗啡具有更好的疗效。OBJECTIVE To compare the effect of dezocine,morphine and nalbuphine in the management of postoperative pain for outpatients.METHODS Adult patients who had arthroscopic surgery under general anesthesia and requested postoperative pain relief were randomized to receive treatment in a double-blind protocol with 5 mg of intravenous dezocine（20 patients）,morphine（22 patients）,nalbuphine（18 patients）,or saline（24 patients）.At 10-min intervals,starting with the first dose of analgesic,patients could choose up to three additional doses of the primary treatment,or choose an alternative analgesic if the primary drug was unsatisfactory.One to four doses of morphine were given as the alternative treatment if the initial treatment was dezocine or nalbuphine,and one to four doses of dezocine were given if the initial treatment was saline or morphine.RESULTS The proportion of patients treated successfully by the initial treatments（i.e.,not requesting alternative treatment）,with P value for difference from placebo treatment,was saline 25%,nalbuphine 33%（P=0.48）,morphine 54%（P=0.026）,and dezocine 75%（P=0.003） respectively.CONCLUSION Dezocine and morphine are more efficacious than nalbuphine in the management of early postoperative pain.As an alternative analgesic in this study,dezocine required fewer doses to achieve patient satisfaction and was thus more efficacious than morphine.

关 键 词：地佐辛 全身麻醉 关节镜 

分 类 号：R969[医药卫生—药理学]