不同剂量地佐辛用于腹部手术患者术后镇痛效果的比较  

Analgesic efficacy of dezocine at distinct dose on acute postoperative pain in patients undergoing abdominal surgery

作　　者：李冰冰[1] 朱巍[1] 陶佳[1] 蒋忠[1] 马正良[1] 

机构地区：[1]南京大学医学院附属鼓楼医院麻醉科,江苏南京210008

出　　处：《南京医科大学学报（自然科学版）》2014年第10期1404-1407,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省自然科学基金(BK2012532);南京市卫生局青年卫生人才项目第二层次

摘　　要：目的：观察两种剂量地佐辛单次静脉注射用于腹部腔镜手术患者的术后镇痛效果及不良反应。方法：60例ASA1~2级择期腹部全麻手术患者,随机分为3组,每组各20例。芬太尼组（F组）：手术结束前30 min给予静脉注射芬太尼1μg/kg镇痛。D1组、D2组：手术结束前30 min分别静脉注射地佐辛100、200μg/kg镇痛。记录拔管后即刻和拔管后2、4、24 h静态疼痛视觉模拟评分（VAS）,拔管后4、24 h活动状态下疼痛VAS评分。记录3组患者术后苏醒时间、镇静水平、术后24 h内氟比洛芬酯用量以及恶心呕吐发生率。结果：在气管导管拔除后2、4、24 h时间点,F组相对于D1、D2组静态疼痛VAS评分明显升高,并且术后24 h氟比洛芬酯用量较D1、D2组明显增加（P〈0.05）;在4、24 h时间点,D2组活动状态下疼痛VAS评分较D1组明显下降（P〈0.05）。3组患者全麻苏醒时间无显著性差异,F组Ramsay镇静评分较D1、D2组降低。3组患者术后24 h内,恶心呕吐发生率无显著性差异（P〉0.05）。结论：地佐辛（100~200μg/kg）单次静脉注射能有效缓解全麻患者术后疼痛,降低术后氟比洛芬酯用量,而且地佐辛（200μg/kg）能缓解患者运动状态下疼痛,有利于患者早期康复。Objective：To observe analgesis effects and safety of dezocine at a distinct dose on postoperative pain control in patients undergoing abdominal endoscopic surgery. Methods： Sixty patients（ASA physical status： Grade 1 ~2） were scheduled to undergo abdominal endoscopic surgeries. Those patients were randomly divided into 3 groups with 20 healthy subjects in each group. The fentanyl group（F group）： the patients were given fentanyl（1 μg / kg） intravenously 30 min prior to the end of surgical procedure. D1, D2group：dezocine（100 μg / kg, 200 μg / kg） was substituted for fentanyl, respectively. The visual analogue scale（VAS） for pain at rest at 2, 4,24 h and in motion was evaluated postoperatively. The time for wake-up from general anesthesia and sedation status of patients after extubation were also recorded. The incidence of postoperative nausea and vomiting（PONV） in 24 h after surgery was recorded. Results：The VAS values at rest at 2, 4, 24 h time points posterior to extubation in F group were higher as compared with D1, D2group（P 〈0.05）. The consumption dose of flurbiprofen for rescue of postoperative pain in F Group was higher than the other two groups（P 〈 0.05）.In addition, the VAS values in motion at 4, 24 h in D2 group were significantly reduced in comparison with D1group（P 〈 0.05）. The Ramsay score in F group was lower than that in D1 and D2group（P 〈 0.05）. There was no significant difference in time for wake-up from general anesthesia and incidence of PONV among three groups. Conclusion： Dezocine at 100~200 μg / kg was effective in alleviation of postoperative pain and decreased the postoperative consumption of flurbiprofen as a remedy for pain control. Furthermore, dezocine（200μg/kg） led to the amelioration of pain in motion and was beneficial in early ambulation for patients.

关 键 词：地佐辛 术后镇痛 腹部腔镜手术 

分 类 号：R614[医药卫生—麻醉学]