地佐辛对游离皮瓣移植术后舒芬太尼镇痛效果的影响  

Influence of dezocine on effect of sufentanyl for postoperative analgesia in patients undergoing the surgery of free skin flap

作　　者：王白云[1] 侯立力[1] 梁娜[1] 罗红菱[1] 

机构地区：[1]南华大学附属南华医院麻醉科,湖南衡阳421002

出　　处：《中国现代医学杂志》2013年第19期68-71,共4页China Journal of Modern Medicine

摘　　要：目的观察地佐辛对游离皮瓣移植术后舒芬太尼镇痛效果的影响。方法选择ASAⅠ-Ⅱ级需行游离皮瓣移植术病例60例,随机分成3组,每组20例。A组术始时和术毕前30 min各静注地佐辛5 mg、B组术毕前30 min静注地佐辛10 mg和C组静注等量生理盐水。术后均采用舒芬太尼自控静脉镇痛(PCIA)。观察记录三组患者术后2、6、12和24 h的VAS疼痛评分和Ramsay镇静评分,术后24 h内两组PCA按压总次数、有效次数和舒芬太尼的用量,观察嗜睡、恶心呕吐、皮肤瘙痒和呼吸抑制等不良反应。结果术后2、6、12和24 h3组VAS疼痛评分A、B组均明显低于C组(P<0.05);术后24 h内PCA按压总次数和有效次数,舒芬太尼的用量A、B组均明显少于C组(P<0.05)。术后2 h和6 h的Ramsay镇静评分A、B组均明显高于C组(P<0.05);但术后2 h的Ramsay镇静评分A组明显低于B组(P<0.05)。A、B组术后恶心呕吐、嗜睡和呼吸抑制均明显低于C组(P<0.05);A组术后嗜睡和呼吸抑制均明显低于B组(P<0.05)。结论静脉注射地佐辛可增强舒芬太尼游离皮瓣移植术后镇痛效果,能减少其用量;术始时和术毕前30 min分别静注地佐辛5 mg,不良反应少,更安全。【Objective】To observe the influence of dezocine on effect of sufentanyl for postoperative analgesia in patients undergoing the surgery of free skin flap.【Methods】60 patients undergoing the surgery of free skin flap,ASAⅠ～Ⅱ level,were randomly divided into three groups,each 20 cases.Group A received intravenousus dezocine 5 mg at the beginning of operation and 30 min before the end of operation,Group B received intravenousus dezocine 10 mg and group C received intravenous NS at 30 min before the end of the operation.PCIA with sufentanyl was used for postoperative analgesia in all patients.VAS was recorded at 2,6,12,and 24 h after operation.The total number and the valid number of pressing PCA pump,the total consumption of sufentanyl and adverse effects were recorded at 24 h after operation.【Results】Compared with group C,there were significant decreases in the score of VAS,sufentanyl consumption,the total number and the valid number of pressing PCA pump in group A and B（P〈0.05） at time points after operation.The scores of Ramsay in group A and B were much higher than those in group C at 2 and 6 h after the operation（P〈0.05）;but the scores of Ramsay in group A were much lower than those in group B at 2 h after the operation（P〈0.05）.The incidences of nausea and vomiting,lethargy and respiratory depress in group A and B were significantly lower than those in group C（P〈0.05）,the incidences of lethargy and respiratory depress in group A were significantly lower than those in group B（P〈0.05）.【Conclusions】Dezocine can enhance the postoperative analgesic efficacy of sufentanyl after the surgery of free skin flap and reduce the sufentanyl con-sumption.The way of dezocine 5mg intravenously injected at he begin of operation and 30 min before the end of operation have lower adverse effects and more safer.

关 键 词：地佐辛 舒芬太尼 术后镇痛 游离皮瓣 

分 类 号：R619[医药卫生—外科学]