地佐辛联合曲马多在全麻苏醒期急性疼痛中的应用  

Effects of dezocine combined with tramadol on acute pain during the recovery period of general anethesia

作　　者：冯慧[1] 王贤裕[1] 秦成名[1] 蒋金龙[1] 王燕[1] 

机构地区：[1]湖北医药学院附属太和医院麻醉科,湖北十堰442000

出　　处：《现代医学》2014年第1期69-72,共4页Modern Medical Journal

摘　　要：目的:探讨地佐辛联合曲马多在全麻苏醒期急性疼痛中应用的有效性及安全性。方法:将120例择期行全麻开腹腹部手术患者随机均分地佐辛组、舒芬太尼组、地佐辛联合曲马多组,每组40例,分别在关腹前30 min静脉注射地佐辛0.1 mg·kg-1、静脉注射舒芬太尼0.1μg·kg-1、肌肉注射地佐辛0.1 mg·kg-1+曲马多2 mg·kg-1。观察3组患者自主呼吸恢复时间、苏醒时间及拔管时间、麻醉恢复室(PACU)停留时间及苏醒期疼痛(VAS)评分、镇静躁动(SAS)评分、舒适度(BCS)评分,并记录呼吸抑制、嗜睡、头晕、恶心、呕吐等不良反应的情况。结果:3组之间自主呼吸恢复时间、苏醒时间、拔管时间比较,舒芬太尼组延长,但差异无统计学意义(P>0.05);3组之间PACU停留时间比较,舒芬太尼组明显延长,差异有统计学意义(P<0.05);3组患者苏醒后的VAS、SAS、BCS评分比较,舒芬太尼组和地佐辛联合曲马多组VAS、SAS评分低于地佐辛组,差异有统计学意义(P<0.05),BCS评分明显高于地佐辛组,差异有统计学意义(P<0.05);地佐辛联合曲马多组不良反应发生率低于地佐辛组、舒芬太尼组。结论:3种给药方式均能有效地缓解麻醉苏醒期急性疼痛,但地佐辛联合曲马多镇痛效果好,作用时间长,苏醒迅速,苏醒质量较高,不良反应最少,优于地佐辛、舒芬太尼。Objective： To investigate the efficacy and safety of dezocine combined with tramadol to postoperative pain in the analepsia stage of general anesthesia. Methods： 120 inpatients of our hospital from January 2012 to December 2012 undergoing open abdominal surgery were randomly divided into 3 groups, dezocine group （group D）, sufentanil group （group S）, and dezocine ＋ tramadol group （group DQ）, 40 cases in each group. 30 minutes before the end of the operation, patients in group D were intravenous injected dezocine 0.1 mg / kg; patients in group S were intravenous injected sufentanil 0.1μg / KG, and patients in group DQ were intramuscular injected dezocine 0.1 mg / kg ＋ tramadol 2mg/kg. we observed the spontaneous breathing recovery time, palinesthesia time and extubation time, postanesthesia care unit （PACU） stay time; Awakening period pain （VAS） score, calm, agitated （SAS） score and comfort （BCS） score, and recorded the respiratory depression, drowsiness, dizziness, nausea, vomiting and other adverse reactions of patients in the 3 groups. Results： Spontaneous breathing recovery time, palinesthesia time, extubation time are longer in group S, but compare with other groups, the differences have no statistically significant.（P〉 0.05）; PACU stay time is longer in group S, the difference has statistically significant （P 〈0.05）; compare the VAS, SAS, BCS scores in 3 groups after palinesthesia, the VAS and SAS are lower in group S and group DQ than in the group D, and the differences have statistically significant （P 〈0.05）; BCS score is higher in group S and group DQ than that in group D, the differences have statistically significant （P 〈0.05）. The incidence of adverse reactions of dezocine combined with tramado group was lower than those of sufentanil group and dezocine group（P 〈0.05）. Conclusions ： Three modes of analgesic drugs could alleviate the acute postoperative pain during the recovery period of general anethesia effectively, but dezocine c

关 键 词：地佐辛 曲马多 全身麻醉 苏醒期 术后疼痛 

分 类 号：R614[医药卫生—麻醉学]