地佐辛对ERCP术患者镇痛、镇静效果及安全性  

Analgesic, sedative effects and safety of dezocine in patients undergoing endoscopic retrograde cholangiopancreatography

作　　者：朱菡[1] 覃华[1] 李德民[1] 王波[1] 张志成[1] 赵秋[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院消化内科,湖北省武汉市430030

出　　处：《世界华人消化杂志》2015年第8期1333-1337,共5页World Chinese Journal of Digestology

摘　　要：目的:评价地佐辛对经内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)术患者的镇痛、镇静效果和安全性.方法:将华中科技大学同济医学院附属同济医院消化内科2013-07/2014-06行ERCP术的140例患者随机分为地佐辛组(n=70)及杜冷丁组(n=70).ERCP术前30 min,地佐辛组患者给予地佐辛5 mg肌肉注射;杜冷丁组患者给予杜冷丁50 mg肌肉注射.分析患者ERCP术中及术后30 min、1、2、3、6 h的疼痛视觉模拟评分(visual analogue scales,VAS评分)、舒适度评分(Bruggrmann comfort scale,BCS评分)以及给药后30 min、1、2、3 h的镇静评分(Ramsay评分),同时观察两组患者腹痛、腹胀、恶心呕吐、头痛头晕、呼吸抑制等不良反应发生率,评价地佐辛对ERCP术患者的镇痛、镇静效果及其安全性.结果:两组患者均顺利完成ERCP检查及治疗,ERCP术中地佐辛组患者VAS评分明显低于杜冷丁组(P<0.05);ERCP术后地佐辛组患者BCS评分均高于杜冷丁组(术后30 min、2 h及3 h两组间B C S评分差异均有统计学意义,P<0.05);ERCP术前30 min肌肉注射地佐辛5 mg及杜冷丁50 mg后患者均能安静合作,两组间Ramsay评分无统计学差异(P>0.05).地佐辛组ERCP术后腹痛、腹胀、恶心呕吐等不良反应发生率均低于杜冷丁组,两组患者均无头痛头晕、呼吸抑制等严重不良反应,地佐辛组患者腹胀发生率明显低于杜冷丁组(P<0.05).结论:地佐辛可安全有效地应用于ERCP术患者的镇痛、镇静治疗,其临床疗效优于杜冷丁.AIM： To evaluate the analgesic, sedative effects and safety of intramuscular dezocine in patients undergoing endoscopic retrograde cholangiopancreatography（ERCP）.METHODS： From July 2013 to June 2014, 140patients undergoing ERCP at our hospital were randomly divided into either a dezocine group（n = 70） or a demerol group（n = 70）. Patients of the dezocine group were injected with 5 mg dezocine intramuscularly 30 min before ERCP, while the demerol group was given demerol 50 mg intramuscularly. The scores of visual analogue scale（VAS） intraoperatively or 30 min, 1, 2, 3, and 6h postoperatively, Bruggrmann comfort scale（ BCS） and Ramsay sedation score（RSS） at 30 min, 1, 2, and 3 h postoperatively were analyzed. The incidences of adverse reactions such as abdominal pain, abdominal distention, nausea, vomiting, headache, dizziness, and respiratory depression were recorded. We then evaluated the safety of dezocine and its analgesic and sedative effects in patients undergoing ERCP. RESULTS： Both groups of patients successfully completed ERCP. Intraoperative VAS score in the dezocine group was significantly lower than that in the demerol group（P〈0.05）. BCS scores in the dezocine group were significantly higher than those in demerol group at 30 min, 2 and 3 h postoperatively（P〈0.05）. There was no significant difference in RSS score between the two groups（P〉0.05）. Administering either 5 mg dezocine or 50 mg demerol 30 min preoperatively had similar analgesic and sedative effects. The incidences of postoperative abdominal pain, abdominal distension, nausea and vomiting in the dezocine group were significantly lower than those in the demerol group（P〈0.05）. No serious adverse reactions such as headache, dizziness or respiratory depression occurred in either group. The incidence of abdominal distension in the dezocine group was significantly lower than that in the demerol group（P〈0.05）.CONCLUSION： Dezocine is safe and effective for analgesia and sedation in the proced

关 键 词：地佐辛 杜冷丁 内镜逆行胰胆管造影术 

分 类 号：R614[医药卫生—麻醉学]