地佐辛联合地塞米松超前镇痛对经肛门手术的影响  

Effect of Dezocine Combined with Dexamethasone Preemptive Analgesia on the Peranum Surgery

作　　者：吴晓珲[1] 岳霞影[1] 薛慧[1] 傅国强[1] WU Xiaohui;YUE Xiaying;XUE Hui;FU Guoqiang(Department of Anesthesia,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,200021 China)

机构地区：[1]上海中医药大学附属曙光医院(东院)麻醉科,上海200021

出　　处：《系统医学》2017年第23期67-70,共4页Systems Medicine

摘　　要：目的观察地佐辛联合地塞米松超前镇痛用于经肛门手术患者的术后镇痛效果。方法将90例ASAⅠ~Ⅱ级的经肛门手术患者(2016年6月—2017年5月)随机分成A、B、C3组,每组30例。A组使用芬太尼1μg/kg、丙泊酚2~3 mg/kg诱导,以丙泊酚6~10 mg/(kg·h)持续输注维持麻醉;患者意识消失后予以肛周神经阻滞麻醉。B组诱导前静脉给予地佐辛0.1 mg/kg,5 min后诱导及维持麻醉与局麻方法同A组。C组诱导前静脉给予地佐辛0.1 mg/kg加地塞米松5 mg,5 min后诱导及维持麻醉与局麻方法同A组。观察患者术后2、6、24 h的VAS评分以及镇痛药追加情况和术后24 h的恶心呕吐评分。结果 3组均顺利完成手术。B组术后2 h VAS评分(1.98±0.70)分、6h VAS评分(2.47±0.51)分、24 h VAS评分(3.49±0.37)分均低于A组(P<0.05);C组术后2 h VAS评分(1.21±0.41)分、6 h VAS评分(2.32±0.64)分、24 h VAS评分(3.43±0.11)分均低于A组(P<0.05)。B组术后2 h镇痛药追加次数(0.23±0.18)次、术后6 h镇痛药追加次数(0.46±0.21)次、术后24 h镇痛药追加次数(0.98±0.47)次均低于A组(P<0.05);C组术后2 h镇痛药追加次数(0.22±0.11)次、术后6 h镇痛药追加次数(0.43±0.29)次、术后24 h镇痛药追加次数(0.96±0.26)次均低于A组(P<0.05)。C组术后2 h恶心评分(0.26±0.11)分、术后6 h恶心评分(0.71±0.21)分、术后24 h恶心评分(0.78±0.47)分均低于A组、B组(P<0.05),C组术后2 h呕吐评分(0.32±0.11)分、术后6 h呕吐评分(0.56±0.29)分、术后24 h呕吐评分(0.58±0.32)分均低于A组、B组(P<0.05)。结论地佐辛联合地塞米松超前镇痛在经肛门手术中运用,具有较好的术后镇痛效果,同时可减少单纯运用地佐辛时的恶心呕吐反应,具有一定的临床应用价值。Objective To observe the effect of dezocine combined with dexamethasone preemptive analgesia on the peranum surgery.Methods 90 cases of patients with peranum surgery of ASA levelⅠ~Ⅱfrom June 2016 to May 2017 were randomly divided into three groups with 30 cases in each group,the group A used the fentanyl 1μg/kg and propofol 2~3 mg/kg for induction,and conducted the continuous infusion of propofol 6~10 mg/(kg·h)for maintaining anesthesia,the group B used the intravenous injection of dezocine 0.1 mg/kg before induction,after 5 min,the patients were induced for maintaining anesthesia,and the local anesthesia method was the same as the group A,and the group C used the intravenous injection of dezocine0.1 mg/kg and dexamethasone 5 mg,after 5 min,the patients were induced for maintaining anesthesia,and the local anesthesia method was the same as the group A,and the VAS score,analgesia drugs additional situation and vomiting and nausea scores in 24 h after surgery of patients in 2,6 and 24 h were observed.Results The three groups finished operation successfully,and the VAS scores in 2 h,6 h and 24 h after surgery in the group B were respectively(1.98±0.70)points,(2.47±0.51)points,(3.49±0.37)points,which were lower than those in the group A(P<0.05),and the VAS scores in 2 h,6 h and 24 h after surgery in the group C were respectively(1.21±0.41)points,(2.32±0.64)points,(3.43±0.11)points,which were lower than those in the group A(P<0.05);and the analgesics additional frequency in 2 h,6 h and 24 h after surgery in the group B were respectively(0.23±0.18),(0.46±0.21),(0.98±0.47),which were lower than those in the group A(P<0.05),the analgesics additional frequency in 2 h,6 h and 24 h after surgery in the group C were respectively(0.22±0.11)points,(0.43±0.29)points,(0.96±0.26)points,which were lower than those in the group A(P<0.05),and the nausea scores in 2h,6h and 24h after surgery in the group C were(0.26±0.11)points,(0.71±0.21)points,(0.78±0.47)points,which were lower than those in the group A and the

关 键 词：地佐辛 地塞米松 超前镇痛 经肛门手术 

分 类 号：R614[医药卫生—麻醉学]