地佐辛超前镇痛对宫颈癌根治术患者的临床价值  

Clinical value of Dezocine Preemptive analgesia in patients scheduled for radical hysterectomy

作　　者：周杰[1] 曾志英[2] 黄美荣[3] 张群锋 刘珏 

机构地区：[1]南华大学附属第二医院妇产科,衡阳421001 [2]南华大学附属第二医院麻醉科,衡阳421001 [3]南华大学后勤集团医疗服务中心,衡阳421001

出　　处：《湖南师范大学学报（医学版）》2015年第3期23-25,共3页Journal of Hunan Normal University(Medical Sciences)

基　　金：湖南省教育厅科研项目(12C0350)

摘　　要：目的:探讨使用地佐辛进行超前镇痛对经腹宫颈癌根治手术患者的临床价值。方法:选取50例择期全麻下行经腹宫颈癌根治术患者,随机分为C、D两组:D组(地佐辛组)于麻醉诱导前20min静脉给予地佐辛(5mL生理盐水中含有地佐辛5mg),C组(控制组)于麻醉诱导前20min静脉直接给予生理盐水5mL;术后患者均给予舒芬太尼静脉自控镇痛泵自主镇痛。各组患者于注射地佐辛(或生理盐水)前(T1)、术后4h(T2)及12h(T3)各时间段抽血进行皮质醇(Cor)、促肾上腺皮质激素(ACTH)和C反应蛋白(CRP)的含量分析。记录患者于经腹宫颈癌根治术后4、8、12、24h的VAS评分。结果:两组在T1和T2时的血浆Cor、ACTH浓度及血清CRP浓度较T3时相比明显升高;而与C组相比,D组在T1和T2时血浆Cor、ACTH浓度及血清CRP浓度均明显降低。术后4、8、12hD组的VAS评分较C组下降;与C组相比,D组术后8、12、24h患者自控镇痛总次数及有效次数减少。结论:使用地佐辛超前镇痛能有效减轻经腹宫颈癌根治术患者的术后应激反应、缓解患者疼痛。Objective To discuss the clinical value of dezocine preemptive analgesia in cervical cancer patients scheduled for radical hysterectomy.Methods Chose fifty cervical cancer patients scheduled by radical hysterectomy,and randomly divided into two groups(C & D).20 minutes before induction of anesthesia,the D group were given Dezocine by intravenous(5ml NS containing 5mg dezocine),and the C group were given 5ml NS directly by intravenous; both groups were given Sufentanil patient-controlled analgesia pump postoperatively.The levels of cortisol(Cor),adrenocorticotropic hormone(ACTH) and C-reactive protein(CRP)in these two groups were evaluated before injected dezocine or NS(T1),at 4 hours after operation(T2) and 12 hours after operation(T3).The VAS score in these two groups were recorded at 4,8,12,24 hours after radical hysterectomy.Results Both groups’ Cor,ACTH,CRP levels at T1 and T2 were obviously higher than that of T3; compared with C group,D group’s Cor,ACTH,CRP levels at T1 and T2 were significantly decreased.4,8,12 hours after operation,D group’s VAS score were lower than group C; compared with C group,D group’s total and effective frequency of patient self-controlled analgesia at 8,12,24 hours after operation were decreased.Conclusion Using dezocine preemptive analgesia can effectively ease cervical cancer patients scheduled for radical hysterectomy of postoperative stress reaction and pain.

关 键 词：宫颈癌 地佐辛 应激 镇痛 

分 类 号：R614[医药卫生—麻醉学] R737.33[医药卫生—外科学]