羟考酮与舒芬太尼分别伍用地佐辛术后镇痛效果比较  

Comparison of the effects of oxycodon and sufentanil combined with dezocine in postoperative analgesia after laparoscopic hysterectomy

作　　者：李蒙蒙[1] 张庆[1] 

机构地区：[1]安徽医科大学附属合肥医院(合肥市第二人民医院)麻醉科,230011

出　　处：《实用疼痛学杂志》2015年第6期433-435,共3页Pain Clinic Journal

摘　　要：目的 比较羟考酮与舒芬太尼分别伍用地佐辛在腹腔镜全子宫切除术术后镇痛的安全性和有效性.方法 择期腹腔镜全子宫切除术患者60例,用随机数字表法分为两组：羟考酮加地佐辛组（OD组）和舒芬太尼加地佐辛组（SD组）.两组术后均给予患者自控镇痛（PCIA）,OD组缝皮前缓慢推注羟考酮0.1 mg/kg,术后羟考酮0.5 mg/kg和地佐辛0.2 mg/kg;SD组缝皮前缓慢推注舒芬太尼0.1μg/kg,术后舒芬太尼2 μg/kg和地佐辛0.2 mg/kg,两组均以0.9％生理盐水稀释至100 ml人泵.记录两组患者术后不同时间的VAS评分和Ramsay评分,观察患者术后的不良反应.结果 与SD组比较,OD组的拔管时间缩短（P＜0.05）,术后不同时间的VAS评分OD组小于SD组（P＜0.05）,Ramsay评分在术后30 min、4h时SD组小于OD组.与SD组比较,OD组术后患者下腹部不适感、恶心呕吐等不良反应的发生率减少（P＜0.05）.结论 羟考酮联合地佐辛术后镇痛效果优于舒芬太尼联合地佐辛,且不良反应少.Objective To evaluate the safety and efficacy of the postoperative analgesia with oxyeodone and dezocine, and compare with sufentanil and dezocine after hysterectomy.Methods Sixty patients undergoing laparoscopic hysterectomy with postoperative intravenous patient controlled analgesia （PCIA） were randomly divided into two groups using a random number table： oxycodone plus dezocine group （group OD） and sufentanil plus dezocine group （group SD）.Patients were given oxycodone 0.1 mg/kg intravenously in group OD and slowly push sufentanil 0.1 ug/kg in group SD before skin closure.PCIA contained oxycodone 0.5 mg/kg plus dezocine 0.2 mg/kg, diluted to 100 ml with 0.9% normal saline in group OD, which was the same in group SD except sufentanil 2 μg/kg instead of oxycodone.VAS and Ramsay scores of the two groups in different time were recoded postoperatively, and the adverse reactions were observed.Results Compared with group SD, postoperative VAS was lower at 30 min,4 h, 12 h,24 h in group OD than that in group SD.Ramsay scores were lower at 30 min, 4 h in group SD than that in group OD.The incidence of postoperative nausea, dizziness, vomit was statistically lower in group OD than that in group SD.Conclusion The postoperative analgesic effect of oxycodone combined with dezocine is better than sufentanil combined with dezocine, with less adverse reaction, after laparoscopic hysterectomy.

关 键 词：羟考酮 地佐辛 舒芬太尼 自控镇痛 

分 类 号：R971.2[医药卫生—药品]