地佐辛复合舒芬太尼在大面积烧伤患者术后自控静脉镇痛中的应用  

Application Effect of Dezocine Combined with Sufentanil in Patients with Extensive Burns after Patient-controlled Intravenous Analgesia

作　　者：王利平 黄艳 苏明萍 冯艳 WANG Li-ping;HUANG Yan;SU Ming-ping;FENG Yan(Department of Anesthesiology,Nanchong Central Hospital,Nanchong 637200,Sichuan,China)

机构地区：[1]南充市中心医院麻醉科,四川南充637200

出　　处：《中国美容医学》2021年第10期55-58,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探究地佐辛复合舒芬太尼在大面积烧伤患者术后自控静脉镇痛(Patient-controlled intravenous analgesia,PCIA)中的应用效果。方法:选择2019年1月-2019年12月笔者医院收治的拟行切削痂自体皮移植手术的烧伤患者作为研究对象。按照随机数字表法分为观察组(54例)及对照组(55例),两组患者术后均建立PCIA静脉通道,对照组镇痛药物为枸橼酸舒芬太尼2.5μg/kg、盐酸托烷司琼6mg,观察组为枸橼酸舒芬太尼2μg/kg、盐酸托烷司琼6mg、地佐辛0.25mg/kg,持续镇痛48h。记录PCIA有效按压次数,收集给药2、6、12、24、48h时平均动脉压(Mean arterial pressure,MAP)、心率(Heart rate,HR)、呼吸频率(Respiratory rate,RR)、血氧饱和度(Blood oxygen saturation,SpO2)、视觉模拟评分(Visual analogue scale,VAS)、Ramasy评分等指标,统计不良反应发生率。结果:两组患者切削痂面积、手术时间、苏醒时间及拔管时间比较差异均无统计学意义(P>0.05)。给药48h内,观察组及对照组PCIA有效按压次数比较差异无统计学意义(P>0.05)。两组患者各时间点MAP、HR、RR、SpO2、VAS评分比较差异无统计学意义(P>0.05)。观察组给药6、12、24、48h时Ramasy评分显著低于对照组,差异有统计学意义(P<0.05)。观察组恶心呕吐、嗜睡发生率及总体不良反应发生率显著低于对照组,差异有统计学意义(P<0.05)。结论:对于大面积烧伤患者,地佐辛复合舒芬太尼PCIA具有可靠的镇痛效果,与舒芬太尼单药效果相当,同时减少了舒芬太尼剂量及不良反应发生率。Objective To explore the application effect of dezocine combined with sufentanil in patients with extensive burns after patient-controlled intravenous analgesia(PCIA).Methods During the period from January 2019 to December 2019,burn patients who were admitted to the hospital and underwent elective eschar shaving autologous skin grafting were enrolled as the research subjects.According to random number table method,they were divided into the observation group(54 cases)and the control group(55 cases).PCIA venous channel was established in both groups after surgery.The analgesic drug in the control group was 2.5μg/kg sufentanil citrate,and 6mg tropisetron hydrochloride.The observation group was 2μg/kg sufentanil citrate,6mg tropisetron hydrochloride and 0.25mg/kg dezocine.The duration of continuous analgesia was 48h.The times of effective PCIA compression were recorded.At 2,6,12,24 and 48h after administration,mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR),blood oxygen saturation(SpO2),scores of visual analogue scale(VAS)and Ramasy were collected.The incidence of adverse reactions was statistically analyzed.Results There was no significant difference in escharectomy area,operation time,recovery time and extubation time between the two groups(P>0.05).Within 48h after administration,there was no significant difference in times of effective PCIA compression between observation group and control group(P>0.05).There were no significant differences in MAP,HR,RR,SpO2 and VAS scores between the two groups at any time point(P>0.05).At 6,12,24 and 48h after administration,Ramsay scores were significantly lower in the observation group than the control group(P<0.05).The incidence of nausea and vomiting,and drowsiness,and total incidence of adverse reactions in the observation group were significantly lower than those in the control group(P<0.05).Conclusion For patients with extensive burns,the analgesic effects of dezocine combined with sufentanil for PCIA are reliable.Its effects are equivalent to those of

关 键 词：地佐辛 舒芬太尼 烧伤 自控静脉镇痛 切削痂自体皮移植 镇静 不良反应 

分 类 号：R644[医药卫生—外科学]