地佐辛复合舒芬太尼用于妇科术后镇痛2936例临床分析  

Clinical analysis on dezocine combined with sufentanil for postoperative analgesia after gynecological surgery in 2936 cases

作　　者：郑华[1] 张咸伟[1] 田玉科[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉科,湖北武汉430030

出　　处：《中国妇幼保健》2014年第33期5516-5518,共3页Maternal and Child Health Care of China

基　　金：国家临床重点专科建设项目〔卫办医政函(2012)983号〕;湖北省自然科学基金项目〔2014CFB293〕;同济医院科研基金项目〔2013A006〕

摘　　要：目的：回顾性分析地佐辛复合舒芬太尼用于妇科术后镇痛的有效性和安全性,探讨其用药剂量的影响因素。方法：选取2013年4月~2014年4月全麻下行妇科手术、术后接受24 h地佐辛（0.15 mg/ml）复合舒芬太尼（0.5μg/ml）自控静脉镇痛（PCIA）的患者共3 031例,最后纳入分析的患者共2 936例。在术后镇痛期间,记录患者静止和活动疼痛评分、镇静评分、心率、血压、脉搏氧饱和度、用药剂量、不良反应及满意度。采用多元线性回归分析患者年龄、身高、体重、手术方式与用药剂量的关系。结果：术后患者静止VAS疼痛评分为（11.85±10.74）分,活动VAS疼痛评分为（14.41±11.45）分,Ramsay镇静评分为2（2,2）;心率为（78±23）次/min,收缩压为（118±28）mm Hg,舒张压为（64±12）mm Hg,脉搏氧饱和度为（96±3）%,对术后镇痛的满意度为5（4,5）。在术后镇痛的不良反应中,恶心呕吐的发生率最高（4.35%）,其次是眩晕（2.72%）、腹胀（1.17%）和呼吸抑制（0.16%）,尿潴留的发生率最低（0.08%）。研究期间无术后镇痛相关的死亡。患者体重显著影响术后镇痛用药剂量〔非标准化系数（95%可信区间）=0.92（1.03,0.82）,标准系数=0.37,P=0.00〕。年龄、身高、体重指数和手术方式对术后镇痛用药剂量无显著影响。结论：地佐辛复合舒芬太尼用于妇科术后患者PCIA的效果确切、不良反应发生率低、患者满意度高,其具体用药剂量受体重等因素的影响。Objective： To retrospectively analyze the efficacy and safety of dezocine combined with sufentanil for postoperative an- algesia after gynecological surgery, explore the influencing factors of dose. Methods： A total of 3 031 patients receiving postoperative patientcontrolled intravenous analgesia （PCIA） by dezocine （0. 15 mg/ml） combined with sufentanil （0. 5 p.g/ml） for 24 hours subsequent to gynecological surgery under general anesthesia were selected from April 2013 to April 2014, 2 936 patients were included into the study finally. Pain scores at rest and during movement, sedation score, heart rate, blood pressure, oxygen saturation, dose, adverse effects and satisfaction degree of the patients were recorded during PCIA. Multivariate linear regression analysis was conducted to analyze the relationship between age, body height, body weight, surgical method and dose. Results： After treatment, VAS score at rest was （ 11.85± 10. 74）, VAS score during movement was （ 14.41 ± 11.45）, Ramsay sedation score was 2 （2, 2）, heart rate was （78 ±23） times per minute, systolic blood pressure was （118 ± 28） mmHg, diastolic blood pressure was （64 ± 12） mmHg, pulse oxygen saturation was （96 ±3） % , the satisfaction degree was 5 （4, 5） . Among adverse effects of PCIA, the incidence rate of nausea and vomiting was the highest （4. 35% ） , followed by dizziness （2. 72% ） , abdominal distension （ 1.17% ） and respiratory depression （0. 16% ） , the incidence rate of urinary retention was the lowest （0. 08% ） . There was no postoperative analgesic -related death during the study period. Weight was significantly associated with dose [ unstandardized coefficient （95% CI） = 0. 92 （ 1.03, 0. 82） ; standardized coefficient = 0. 37, P = 0. 00 ] . Age, body height, BMI and surgical method had no significant impact on dose. Conclusion： PCIA by dezocine combined with sufentanil for postoperative analgesia after gynecological surgery is effective, the incidenc

关 键 词：地佐辛 舒芬太尼 术后镇痛 患者自控镇痛 妇科手术 

分 类 号：R984[医药卫生—药品]