地佐辛超前镇痛用于锁骨下臂丛神经阻滞的效果评价  

Effect Evaluation of Dezocine Preemptive Analgesia on Infraclavicular Brachial Plexus Block

作　　者：党丹丹[1] 谢致 车薛华[1] 

机构地区：[1]复旦大学附属华山医院麻醉科,上海200040 [2]上海国际医学中心麻醉科,上海201318

出　　处：《中国临床医学》2014年第6期668-670,共3页Chinese Journal of Clinical Medicine

摘　　要：目的：观察地佐辛超前镇痛用于臂丛神经阻滞的效果及对术后疼痛的影响。方法：将美国麻醉医师协会（ASA）分级Ⅰ~Ⅱ级、行锁骨下臂丛神经阻滞的60例手术患者随机分为3组,每组20例。A组将地佐辛5 mg与局部麻醉药（0.375%罗哌卡因20 mL＋1%利多卡因15 mL＋1∶20万肾上腺素1 mL）混合用于臂丛神经阻滞。B组于术前15 min静脉注射地佐辛5 mg,联合局部麻醉药（同A组）;C组仅行锁骨下臂丛神经阻滞,局部麻醉药同A组。记录麻醉起效时间,手术时间,麻醉后1 h及术后4、8、12、24、36、48 h的疼痛视觉模拟评分（VAS）,术后镇痛持续时间（术毕至术后VAS〉3分的时间）,不良反应。结果：A组麻醉起效时间低于B、C组（P〈0.05）。A、B组术后8 h时的VAS明显低于C组（P〈0.05）;A组术后12、24 h时的VAS明显低于B、C组（P〈0.05）;3组麻醉后1 h及术后4、36、48 h时的VAS差异无统计学意义（P〉0.05）。术后镇痛持续时间为A组〉B组〉C组,差异有统计学意义（P〈0.05）;A组和B组不良反应发生率差异无统计学意义（P〉0.05）。结论：地佐辛超前镇痛效果确切,能够延长术后镇痛时间,且不良反应少。Objective：To observe the effect of dezocine preemptive analgesia on infraclavicular brachial plexus block and the impact of it on postoperative analgesia.Methods：Sixty patients,who were classified by American Society of Anesthesiologists（ASA）criteria as classⅠ-Ⅱ and underwent infraclavicular brachial plexus block,were divided randomly into three groups,with 20 cases in each group.In Group A,5 mg dezocine was combined with local anesthetics（20 mL0.375 %ropivacaine,15mL1%lidocaine and 1mL1∶200 000 epinephrine）for infraclavicular brachial plexus block;in Group B,5mg dezocine was intravenously injected 15 minutes before the operation and then the same local anesthetics were used;in Group C,infraclavicular brachial plexus block was performed only with the same local anesthetics.The onset time of anesthesia and the operation time,the visual analogue scale（VAS）at 1 h after anesthesia and 8,12,24,36,48 h after operation and the postoperative analgesia time（the time from the end point of operation to the time point when VAS〉3）,as well as the side effects were recorded.Results：The onset time of anesthesia in Group A were shorter than that in Group B and C（P〈0.05）.The VAS at 8 h after operation in Group A and B were significantly lower than that in Group C（P〈0.05）.The VAS at postoperative 12 and 24 h in Group A were significantly lower than those in Group B and C.There was no statistically significant difference in VAS score at1 h after anesthesia and at 4,36,48 h after operation among the three groups（P〈0.05）.The analgesia duration was gradually decreased in Group A,B and C（P〉0.05）.There was no statistically significant difference between Group A and B in the incidence of side effects.Conclusions：The dezocine preemptive analgesia has exact effect.It could prolong the duration of postoperative analgesia and has few side effects.

关 键 词：地佐辛 超前镇痛 锁骨下臂丛神经阻滞 

分 类 号：R614.1[医药卫生—麻醉学]