预先注射地佐辛联合地塞米松在宫腔镜手术中的应用及对患者术后的镇痛效果  

Application of pre-injection of dezocine combined with dexamethasone in hysteroscopic surgery and its postoperative analgesia

作　　者：王加仑 李建[1] 林凤颜 廉海光 WANG Jia-lun;LI Jian;LIN Feng-yan;LIAN Haiguang(Department of Anesthesiology,Haikou Women and Children's Health Hospital,Haikou 570206,China)

机构地区：[1]海南省海口市妇幼保健院麻醉科,海南海口570206

出　　处：《实用药物与临床》2019年第4期401-404,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨预先注射地佐辛联合地塞米松在宫腔镜手术中的应用效果及其对患者术后的镇痛效果。方法选取2014年1月至2017年12月我院收治的245例拟行无痛宫腔镜手术治疗的患者,随机分为研究组(122例)和对照组(123例)。两组均采用静脉注射丙泊酚进行麻醉,研究组术前15 min注射地佐辛+地塞米松,对照组静脉注射等量的生理盐水。记录两组患者麻醉效果、VAS/Ramsay评分、HR和MAP的变化,统计两组不良反应发生情况。结果与对照组比较,研究组丙泊酚用量、输液量减少(P<0.01),睁眼时间及定向力恢复时间缩短(P<0.01)。从术前20 min至术后30 min的4个时间点,患者HR、MAP比较差异均无统计学意义(P>0.05),且各时间点两组比较差异亦无统计学意义(P>0.05)。术后8、12、24 h,研究组患者VAS评分低于对照组,且增加镇痛药物使用的患者少于对照组(P<0.01)。术后12 h,研究组Ramsay评分为1分的患者比例低于对照组(P<0.01),2～4分患者比例高于对照组(P<0.01)。研究组不良反应总发生率低于对照组(P<0.01)。结论宫腔镜手术中预先注射地佐辛联合地塞米松具有较好的术后镇痛、镇静效果,降低了丙泊酚的用量,减少了不良反应的发生,麻醉效果显著。Objective To investigate the effect of pre-injection of dezocine combined with dexamethasone on hysteroscopic surgery and postoperative analgesia.Methods A total of 245 patients undergoing painless hysteroscopic surgery in our hospital from January 2014 to December 2017 were selected and randomly divided into study group(n=122)and control group(n=123).Intravenous propofol was used for anesthesia in the two groups.Patients in study group received dezocine combined with dexamethasone at 15 min before operation,while patients in control group were intravenously injected with an equal amount of physiological saline.The anesthesia effect,VAS/Ramsay score,HR and MAP changes were recorded,and the incidence of adverse reactions was recorded.Results Compared with control group,the propofol dose and infusion volume in study group were decreased(P<0.01),and the blinking time and orientation recovery time in study group were shortened(P<0.01).From 20 min before operation to 30 min after operation,there was no significant difference in HR or MAP at the four time points(P>0.05),and nor was there difference between the two groups at each time point(P>0.05).The VAS scores in study group were lower than those of control group at 8,12,and 24 h after surgery,and there were fewer patients needing more analgesic drugs in study group(P<0.01).The proportion of patients with Ramsay score being 1 in study group at 12 h after surgery was lower than that in control group(P<0.01),and the patients with Ramsay being 2 ~ 4 in study group counted for larger proportion than control group(P<0.01).The total incidence rate of adverse reactions in study group was lower than that in control group(P<0.01).Conclusion Pre-injection of dezocine and dexamethasone has postoperative analgesic and sedative effects in hysteroscopic surgery,and it can reduce the amount of propofol and the occurrence of adverse reactions,which has significant anesthetic effects.

关 键 词：宫腔镜 地佐辛 地塞米松 镇痛 

分 类 号：R614[医药卫生—麻醉学]