地佐辛用于全麻患者术后自控静脉镇痛的效果  

Efficacy of dezocine in patients with patient controlled intravenous analgesia after general anesthesia

作　　者：郭训[1] 李恒[1] 梁秀生[1] 邵兵[1] 林赳扬 刘玉妍[1] 张耀之[1] 陆文敏[1] 

机构地区：[1]暨南大学医学院附属清远医院,清远市人民医院麻醉科,广东省清远市511518

出　　处：《实用疼痛学杂志》2013年第5期352-355,共4页Pain Clinic Journal

基　　金：广东省医学科学技术研究基金项目（项目编号：A2012771）

摘　　要：目的 探讨地佐辛用于全麻患者术后自控静脉镇痛（PCIA）的临床疗效.方法 全麻手术患者90例随机分为3组（n=30）,地佐辛组（D组）、芬太尼组（F组）和曲马朵组（T组）.分别于手术结束前15 min静脉注射地佐辛0.1 mg/kg,芬太尼1tμg/kg,曲马朵2 mg/kg作为PCIA的负荷剂量,拔管后启动静脉镇痛泵并持续48 h,分别泵内加入地佐辛0.8 mg/kg,芬太尼15 μg/kg,曲马朵12mg/kg,各组均加托烷司琼5 mg,均以生理盐水稀释成100ml,背景剂量2 ml/h,锁定时间15 min,单次按压负荷量0.5 ml.记录3组患者术后的镇痛评分（VAS）、舒适度评分（BCS）、镇静评分（Ramsay）、PCA总按压次数、PCA有效按压次数及不良反应.结果 与F组比较,D组术后各时点BCS评分、Ramsay评分升高,PCA总按压次数与PCA有效按压次数及不良反应总发生率减少（P＜0.05）,VAS评分差异无统计学意义（P＞0.05）；与T组比较,D组术后各时点VAS评分降低,BCS评分和Ramsay评分升高,PCIA期间PCA总按压次数、PCA有效按压次数及不良反应总发生率减少（P＜0.05）.结论 地佐辛可安全有效地用于全麻患者术后自控静脉镇痛.Objective To explore the clinical efficacy of dezocine in patients with patient con- trolled intravenous analgesia （PCIA） after general anesthesia. Methods Ninety patients under gen- eral anesthesia were randomly divided into 3 groups （n= 30） ： dezocine group （group D）, fentanyl group （group F） and tramadol group （group T）. All patients received PCIA after the operation and lasting for 48 h, the loading dose of PCIA was injected intravenously 15 rain before the end of opera- tion. Patients in group D were received loading dose of dezocine 0. 1 mg/kg, PCIA with dezocine 0. 8 mg/kg and tropisetron 5 mg; group F were received fentanyl 1 μg/kg, PCIA with fentanyl 15 μg/kg and i tropisetron 5 rag; group T were received tramadol 2 mg/kg, PCIA with tramadol 12 mg/kg and tro- pisetron 5 mg respectively. All drugs were diluted to 100 ml with normal saline in the three groups, background dose 2 ml/h, locking time 15 rain and bolus 0.5 ml/per time. VAS, BCS, Ramsay score, total PCA times, effective PCA times and the incidences of side effects were recorded. Results Compared with group F, BCS and Ramsay score in group D were increased at each time point afterthe operation, the total PCA times, effective PCA times and the total adverse reactions of PCIA in group D were decreased（P〈0.05）, there was no significant difference in VAS between the two groups（P〉0.05）. Compared with group T, VAS was decreased , BCS and Ramsay score were in- creased in group D at each time point after the operation, the total PCA times, effective PCA times and the total adverse reactions of PCIA in group D were decreased（P〈0. 05）. Conclusion Dezocine can be safely and effectively used for postoperative PCIA in surgical patients after general anesthesia.

关 键 词：地佐辛 芬太尼 曲马朵 镇痛 患者自控 

分 类 号：R614[医药卫生—麻醉学]