地佐辛用于小儿快通道心脏麻醉术后镇痛的临床应用  

Efficacy of Dezocine for Postoperative Analgesia in Children Undergoing Fast Tracking Cardiac Anesthesia

作　　者：刘佳[1] 董盛龙[2] 陈勇[1] 李娜[1] 

机构地区：[1]海南省人民医院麻醉科,海口570311 [2]海口市人民医院麻醉科,570208

出　　处：《医学研究杂志》2015年第5期121-123,共3页Journal of Medical Research

摘　　要：目的研究地佐辛用于小儿先心病快通道麻醉术后镇痛的效果及相应并发症。方法 60例ASAⅠ或Ⅱ级行房缺、室缺修补的患儿,根据镇痛药物的不同,按随机、双盲方法分为生理盐水组(A)组(n=20),地佐辛肌内注射组(B)组(n=20)和地佐辛静脉注射组(C)组(n=20)。分别于关闭胸骨时(约手术结束前20min)给予生理盐水,地佐辛0.2mg/kg肌内注射,地佐辛0.1mg/kg静脉注射。观察记录3组患儿手术结束后苏醒时间、拔管时间,转出ICU时间,并记录麻醉苏醒时(T1)、拔管时(T2)、转出ICU时(T3)各时间点的平均动脉压(MAP)、心率(HR)、疼痛学VAS评分及镇静评分,以及术后并发症情况。结果与A组相比,B、C两组患儿,各时点的血流动力学更稳定,镇痛镇静程度较好,差异具有统计学意义。B组苏醒时间较A、C组时间长,但ICU停留时间较之缩短,差异具有统计学意义。B组与C相比,在转出ICU时,镇痛镇静指数较低,差异具有统计学意义。A组患儿要求额外镇痛例数较多,A组、C组各有1例发生恶心、呕吐。A组有3例发生寒战。结论地佐辛应用于小儿快通道心脏麻醉术后镇痛效果安全、确切,且肌内注射时的镇痛效果更持久,不良反应最少。Objective To investigate the safety and efficacy of dezocine for postoperative analgesia in children undergoing fast track- ing cardiac anesthesia. Methods In a randomized, double - blind study, Sixty children,20 cases in each group, with atrial septal defect or ventrucular septal defect were divided into saline group （ A, n = 20） and dezocine intramuscular injection group （ B, n = 20） , dezocine intravenous injection group （C, n = 20）. The group of drugs （normal saline 10ml, dezocine 0.2mg/kg im, dezocine 0.1 mg/kg iv） were respectively injected when the suturing sternum （almost 20 minutes before the operation completion）. The times of awake （T1 ） , extubation （T2 ）and discharge from ICU （T3） were recorded. HR, MAP, the Children＇s Hospital of Wisconsin Sedation Scale （CHW）, visual ana- logue scale（VAS） and several adverse effects at three time points after surgery were also recorded. All results were recorded by a doctor. Results Group B and C were haemodynamically stable and VAS and CHW was lower than group A significantly. The awake time in group B was longer than group A and C, and the difference was significant（ P 〈 0.05 ）. Compared with group C, VAS and CHW in group B at the time of discharge from ICU was lower significantly（P 〈0.05）. The more cases in group A received aditional analgesic drugs. One case in group A and C presented nausea and vomit,and three cases in group A shiver. Conclusion Dezocine analgesia can effectively and safely relieve postoperative pain in children undergoing fast tracking cardiac anesthesia, when it was uesd by intramuscular injection the effect is more durable, and without increasing adverse effects.

关 键 词：地佐辛 快通道心脏麻醉 镇痛 

分 类 号：R452[医药卫生—治疗学]