地佐辛持续静脉泵注与口服非甾体抗炎药用于肺癌根治术后患者的镇痛效果  

Analgesic Effect of Continuous Intravenous Injection of Dezocine and Oral Non-steroidal Anti-inflammatory Drugs in Patients with Lung Cancer after Radical Surgery

作　　者：王月珍 李晓 李朝光 WANG Yue-Zhen;LI Xiao;LI Chao-Guang(Department of Pharmacy,The Ninth People's Hospital of Suzhou,Suzhou 215200,China;Department of Anesthesiology The Ninth People's Hospital of Suzhou,Suzhou 215200,China;Department of Anesthesiology,Jiangsu Shengze Hospital,Suzhou 215200,China)

机构地区：[1]苏州市第九人民医院药学部 [2]苏州市第九人民医院麻醉科 [3]江苏盛泽医院麻醉科

出　　处：《中国药物经济学》2024年第12期88-92,共5页China Journal of Pharmaceutical Economics

摘　　要：目的探讨地佐辛持续静脉泵注与口服非甾体抗炎药用于肺癌根治术后患者的镇痛效果。方法选取苏州市第九人民医院2022年5月至2024年5月收治的80例实施肺癌根治术患者作为研究对象,随机分为非甾体抗炎药组及地佐辛组,各40例。所有患者术中均采取咪达唑仑、丙泊酚、舒芬太尼、氯化琥珀胆碱进行全身麻醉诱导。非甾体抗炎药组术前1 h口服200 mg塞来昔布胶囊、术后6 h口服400 mg塞来昔布胶囊,并每隔12 h口服200 mg塞来昔布胶囊,地佐辛组术后将0.3 mg/kg地佐辛与0.9%氯化钠注射液100 ml混合后实施自控静脉镇痛,持续剂量为0.5 mg/L,负荷剂量为5 ml。比较两组患者术后2 h、6 h、12 h、1 d、2 d及3 d镇痛、镇静效果,手术前后氧化应激反应指标,不同时间T淋巴细胞亚群,术后镇痛不良反应发生率。结果地佐辛组术后2 h、6 h、12 h、1 d、2 d及3 d视觉模拟评分法(VAS)评分均低于非甾体抗炎药组(P<0.05);地佐辛组术后2 h、6 h、12 h、1 d、2 d及3 d的Ramsay评分均低于非甾体抗炎药组(P<0.05);术前两组丙二醇(MAD)、超氧化物歧化酶(SOD)水平比较无差异(P>0.05),术后3 d两组MAD、SOD水平均升高,但地佐辛组均低于非甾体抗炎药组,差异有统计学意义(P<0.05);术前两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平对比无差异(P>0.05),术后12 h、72 h地佐辛组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均高于非甾体抗炎药组(P<0.05);两组术后镇痛不良反应发生率对比无差异(P>0.05)。结论与口服非甾体抗炎药相比,肺癌根治术患者术后采用地佐辛持续静脉泵注的镇痛、镇静效果更优,且可改善患者氧化应激反应,提高免疫功能,安全性较高。Objective To explore the analgesic effect of continuous intravenous injection of dezocine and oral non-steroidal anti-inflammatory drugs in patients with lung cancer after radical surgery.Methods A total of 80 patients undergoing radical resection for lung cancer admitted to the Ninth People's Hospital of Suzhou City from May 2022 to May 2024 were selected as the study objects and randomly divided into NSAIDS group and Dezocine group,with 40 patients in each group.All patients were induced by general anesthesia with midazolam,propofol,sufentanil and succincholine chloride.Nonsteroidal anti-inflammatory drug group received 200mg celecoxib capsule 1 h before surgery,400 mg celecoxib capsule 6 h after surgery,and 200 mg celecoxib capsule every 12 h.Observation group received 0.3 mg/kg dezocine mixed with 0.9%sodium chloride injection 100 ml after surgery for self-controlled intravenous analgesia.The sustained dose was 0.5 mg/L and the load dose was 5 ml.The effects of analgesia and sedation 2 h,6 h,12 h,1 d,2 d and 3 d after surgery,oxidative stress indexes before and after surgery,T lymphocyte subsets at different times,and the incidence of postoperative analgesia adverse reactions were compared between the two groups.Results The visual analogue scale(VAS)scores of patients in the dexmedetomidine group were lower than those in the nonsteroidal anti-inflammatory drug group at 2hours,6 hours,12 hours,1 day,2 days,and 3 days after surgery(P<0.05);The Ramsay scores of patients in the Dizocin group were lower than those in the nonsteroidal anti-inflammatory drug group at 2,6,12,1,2,and 3 hours after surgery(P<0.05).There was no significant difference in the levels of propylene glycol(MAD)and superoxide dismutase(SOD)between the two groups of patients before surgery(P>0.05).On postoperative day 3,MAD and SOD levels increased in both groups of patients,but were lower in the dexmedetomidine group than in the nonsteroidal anti-inflammatory drug group,with statistical significance(P<0.05).There was no significant difference

关 键 词：地佐辛 非甾体抗炎药 肺癌根治术 塞来昔布胶囊 镇痛镇静 免疫功能 

分 类 号：R734.2[医药卫生—肿瘤] R979.1[医药卫生—临床医学]