地塞米松用于胸腔镜肺癌根治术患者多模式镇痛的有效性和安全性  

Efficacy and safety of dexamethasone on postoperative multimodal analgesia in patients undergoing thoracoscopic radical resection for lung cancer

作　　者：张云霄[1] 李宗超 陈冀衡[1] ZHANG Yun-xiao;LI Zong-chao;CHEN Ji-heng(Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing),Department of Anesthesiology,Peking University Cancer Hospital&Institute,Beijing 100142,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所麻醉科,恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《中国新药杂志》2020年第23期2700-2704,共5页Chinese Journal of New Drugs

摘　　要：目的:观察地塞米松用于胸腔镜肺癌根治术患者多模式镇痛的有效性和安全性。方法:拟行胸腔镜肺癌根治术患者50例,随机分为地塞米松组24例和对照组26例。入室后分别给予两组患者地塞米松10 mg(2 mL)或氯化钠注射液2 mL静脉注射,常规麻醉及手术,术后连接患者静脉自控镇痛(patient controlled intravenous analgesia,PCIA)。主要研究终点:术后24 h、48 h疼痛视觉模拟评分(visual analogue scale,VAS);次要研究终点:术后镇痛药用量、镇痛泵按压次数及术后并发症和不良事件发生率。结果:与对照组相比,地塞米松组术后24 h动、静态及48 h动态VAS评分较低(P<0.05);术后24 h镇痛泵用药量及补救镇痛药剂量较低(P<0.05);术后镇痛泵无效按压次数及无效/总按压次数较低(P<0.05)。结论:围术期地塞米松可降低胸腔镜肺癌切除术患者术后疼痛评分,减少术后阿片类镇痛药用量,不增加术后并发症和不良事件发生率,可安全有效用于此类患者多模式镇痛。Objective: To observe the efficacy and safety of perioperative dexamethasone on postoperative multimodal analgesia in patients undergoing thoracoscopic radical resection for lung cancer.Methods: 50 patients undergoing thoracoscopic radical resection for lung cancer in Peking University Cancer Hospital were randomly divided into dexamethasone group(24 cases) or control group(26 cases).Intravenous dexamethasone 10 mg(2 mL) or saline 2 mL was administered to the 2 groups,respectively.Anesthesia and surgery were performed routinely.The patient controlled intravenous analgesia(PCIA) were connected after the recovery of anesthesia.The main endpoints of this study were VAS at 24 h and 48 h after operation,and the secondary endpoints included the dosage of analgesic drugs,the times of PCA,and the incidence of postoperative complications and adverse events.Results: Compared with control group,the dynamic and static VAS at 24 h after operation and the dynamic VAS at 48 h after operation in dexamethasone group were lower(P<0.05) in dexamethasone group.The dosage of analgesics consumed for PCA at 24 h after operation as well as those for remedial analgesia were both lower in dexamethasone group(P<0.05).The times of invalid PCA and proportion of invalid PCA/total PCA in the dexamethasone group were also lower than those in control group(P<0.05).Conclusion: Perioperative dexamethasone reduced pain score and the amount of consumed analgesics after thoracoscopic radical resection for lung cancer without increased complications and adverse events.It can be safely and effectively used for multimodal analgesia.

关 键 词：地塞米松 胸腔镜手术 肺癌 多模式镇痛 疼痛视觉模拟评分 

分 类 号：R971.2[医药卫生—药品]