不同剂量地佐辛复合舒芬太尼静脉自控镇痛在后路腰椎术后的应用效果  

Effect of patient-controlled intravenous analgesia with different doses of dezocine combined with sufentanil after posterior lumbar surgery

作　　者：张健星 Zhang Jianxing(Department of Anesthesiology,Central Hospital of Jiaozuo Coal Group Co.,Ltd,Jiaozuo 454000,China)

机构地区：[1]焦作(煤业)集团有限责任公司中央医院麻醉科,焦作454000

出　　处：《中国实用医刊》2022年第20期33-36,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨不同剂量地佐辛复合舒芬太尼静脉自控镇痛(PCIA)在后路腰椎术后的应用效果。方法抽取焦作(煤业)集团有限责任公司中央医院2020年2月至2022年1月收治的66例行后路腰椎手术患者为研究对象,按随机数字表法分为A、B、C三组,每组22例。A组术后给予1μg/ml舒芬太尼自控镇痛,B组手术后给予0.2 mg/kg地佐辛+1μg/ml舒芬太尼自控镇痛,C组手术后给予0.3 mg/kg地佐辛+1μg/ml舒芬太尼自控镇痛,比较三组患者术后24 h内的PCIA次数,以及不同时间点疼痛视觉模拟评分法(VAS)评分、Ramsay镇静量表(RSS)评分,统计不良反应发生情况。结果三组患者术后24 h内各时间段PCIA次数比较,差异未见统计学意义(P>0.05);三组患者镇痛后2、4、8、12、24、48 h VAS评分比较差异有统计学意义(P<0.05),且B、C组患者术后不同时间点的VAS评分低于A组(P<0.05);三组患者镇痛后2、4、8、12、24、48 h RSS评分比较差异有统计学意义(P<0.05),且C组患者术后不同时间点的RSS评分高于A、B组(P<0.05);三组患者不良反应总发生率比较,差异未见统计学意义(P>0.05)。结论不同剂量地佐辛复合舒芬太尼应用在后路腰椎术后PCIA,效果确切,应用0.3 mg/kg地佐辛+1μg/ml舒芬太尼较为合适,其镇痛、镇静效果显著,且安全性良好。Objective To investigate the application effect of patient-controlled intravenous analgesia(PCIA)with different doses of dezocine combined with sufentanil after posterior lumbar surgery.Methods Sixty-six patients who underwent posterior lumbar surgery in Central Hospital of Jiaozuo Coal Group Co.,Ltd.from February 2020 to January 2022 were selected,and they were divided into group A,group B and group C by random number table method,with 22 cases in each group.After operation,group A was given PCIA with 1μg/ml of sufentanil,group B was given PCIA with 0.2 mg/kg of dezocine combined with 1μg/ml of sufentanil,and group C was given PCIA with 0.3 mg/kg of dezocine combined with 1μg/ml of sufentanil.The times of PCIA within 24 h after surgery,visual analogue scale(VAS)score and Ramsay sedation scale(RSS)score were compared among the three groups.Adverse reactions of the three groups were counted.Results There was no significant difference in times of PCIA within 24 h after surgery among the three groups(P>0.05).There were significant differences in VAS score among the three groups at 2,4,8,12,24,48 hours after analgesia(P<0.05),and VAS scores in the group B and group C were significantly lower than those in group A at every time point after surgery(P<0.05).There were significant differences in RSS score among the three groups at 2,4,8,12,24,48 hours after analgesia(P<0.05),and RSS scores in the group C were significantly higher than those in the group A and group B at every time point after surgery(P<0.05).There was no significant difference in the overall incidence of adverse reactions among the three groups(P>0.05).Conclusions Applying PCIA with different doses of dezocine combined with sufentanil all can achieve analgesic ideal effects after posterior lumbar surgery,but 0.3 mg/kg dezocine combined with 1μg/ml sufentanil can achieve more significant analgesic and sedative effects,with good safety.

关 键 词：舒芬太尼 地佐辛 后路腰椎手术 不同剂量 静脉自控镇痛 

分 类 号：R614[医药卫生—麻醉学]