地佐辛对鞘内吗啡镇痛致皮肤瘙痒的影响  

Effects of dezocine on intrathecal morphine-induced pruritus in patients

作　　者：庞君 崔剑 王哲 王慧 师高翔 庄萍 王晓鹏 PANG Jun;CUI Jian;WANG Zhe;WANG Hui;SHI Gao-xiang;ZHUANG Ping;WANG Xiao-peng(Department of Anesthesiology y Shanxi Bethune Hospital,Taiyuan 030032,Shanxi Provine,China;Department of Anesthesiology,Tianjin Central Hospital of Gynecology Obstetrics,Tianjin 300100,China)

机构地区：[1]山西白求恩医院麻醉科,山西太原030032 [2]天津市中心妇产科医院麻醉科,天津300100

出　　处：《中国临床药理学杂志》2021年第6期665-667,共3页The Chinese Journal of Clinical Pharmacology

基　　金：山西省科学技术厅重点研发计划(指南)基金资助项目(201703D321027-6)。

摘　　要：目的观察地佐辛对鞘内吗啡镇痛致皮肤瘙痒的影响。方法选择择期在蛛网膜下腔阻滞麻醉下进行关节镜前交叉韧带重建术患者120例,用随机数字表法分为试验组和对照组,每组60例。试验组穿刺前10 min静脉注射地佐辛0.1 mg·kg^(-1)(生理盐水稀释至2 mL),对照组静脉注射生理盐水2 mL。所有患者选择L3-4间隙进行穿刺,穿刺成功后于蛛网膜下腔给予1%罗哌卡因2 mL、吗啡0.3 mg。记录给药后24 h内患者瘙痒程度评分,同时记录Ramsay镇静评分,视觉模拟评分(VAS)及寒战、恶心、呕吐、低血压和呼吸抑制等药物不良反应发生情况。结果给药后24 h,对照组和试验组的瘙痒发生率分别为38.3%,20.0%,给药1 h后Ramsay镇静评分分别为(2.1±0.4),(3.2±0.7)分,差异有统计学意义(P<0.05);2组VAS评分和药物不良反应发生率差异无统计学意义。结论地佐辛可以有效缓解鞘内吗啡镇痛引发的皮肤瘙痒,且具备可接受的镇静作用。Objective To explore the effects of dezocine on intrathecal morphine-induced pruritus in patients.Methods A total of 120 patients who underwent arthroscopic anterior cruciate ligament reconstruction were randomly divided into control group with 60 cases and treatment group with 60 cases.Treatment group was intravenously injected dezocine 0.1 mg·kg^(-1)(diluted to normal saline 2 mL),control group was intravenously injected normal saline 2 mL at 10 min before spinal anesthesia.All patients were received spinal anesthesia in L3-4 interspace and subarachnoid injection of 1%ropivacaine 2 mL and morphine 0.3 mg.Pruritus severity score in 24 h after administration,Ramsay sedation score,visual analogue scale(VAS),chills,nausea,vomiting,hypotension and respiratory depression of the patients were recorded.Results Within 24 h after administration,the incidence of pruitus in control group and treatment group were 38.3%and 20.0%,the Ramsay sedation score at 1 h after administration in control group and treatment group were 2.1±0.4 and 3.2±0.7,with signigficant difference(P<0.05).There was no significant difference in VAS and the incidence of adverse drug reactions between the two groups.Conclusion Dezocine can relieve intrathecal morphine-induced pruritus in patients and produce a certain sedation effect.

关 键 词：地佐辛 鞘内吗啡 镇痛 瘙痒 

分 类 号：R971.2[医药卫生—药品]