地佐辛超前镇痛对上肢骨折手术患者镇痛效果观察  

Clinical Research of Dezocine on Preemptive Analgesia in Patients Undergoing Upper Limb Operation

作　　者：王丽[1] 林涵淼 高艳[1] 姚杰[1] 赵金石[1] 邢珍[1] 滕金亮[1] 李福龙[1] 

机构地区：[1]河北北方学院附属第一医院麻醉科,河北张家口075000 [2]张家口市沙岭子医院,河北张家口075000

出　　处：《河北北方学院学报（自然科学版）》2015年第6期67-70,共4页Journal of Hebei North University:Natural Science Edition

基　　金：张家口市2013年度科学技术研究与发展计划自筹经费项目(No.1321086D)

摘　　要：目的探讨地佐辛超前镇痛对上肢骨折手术患者的镇痛效果。方法选择术前ASAⅠ~Ⅱ级行择期上肢骨折手术的患者60例,均术前10 in静脉注射咪达唑仑2 mg,阿托品0.3 mg,术中均在神经刺激仪引导下行肌间沟臂丛神经阻滞麻醉,阻滞效果均满意。随机分为实验组(A组)和对照组(B)组各30例,A组手术结束前30 min静脉注射地佐辛0.1 mg·kg^(-1),B组手术结束后30 min静脉注射地佐辛0.1 mg·kg^(-1)。记录2组术前、术中及术后1、2、4、8、12 h血压、疼痛程度(VAS评分法)、术后不良反应,术后1、2、4、8、12 h抽取静脉血用硝酸还原酶法和放免法测定血液中P物质及NO含量。结果 A组与B组术后各时间点血液中P物质及NO含量比较差异有显著性(P<0.05);A组术后各时点VAS值明显低于B组(P<0.05);术后A、B组恶心、呕吐等不良反应差异元显著性(P>0.05);A、B组术前、术中血压比较差异无显著性(P>0.05),A组术前、术中与术后血压比较差异无显著性(P>0.05),B组术后各时点血压与A组比较差异有显著性(P<0.05)。结论地佐辛超前镇痛可以明显减轻上肢骨折手术患者术后疼痛程度,稳定术后患者生命体征,减少围术期疼痛相关因子产生。Objective To investigate the effects of dezocine on preemptive analgesia in patients undergoing upper limb operation.Methods Sixty ASA Ⅰ~Ⅱ patients scheduled for upper limb operation were enrolled in this study.Intravenous gather was inserted after patients arriving at operation room.Midazolam 3 mg and atropin 0.3 mg was injected intravenously 10 min before surgery.All patients were successfully performed interscalene brachial plexus block guided by nerve stimulator.Patients were randomly divided into two groups:group A(n=30) and group B(n=30).Patients in group A were injected intravenously dezocine 0.1 mg·kg^(-1) 30 min before the end of surgery.Patients in group B were injected intravenously dezocine 0.1 mg·kg^(-1) 30 min after the end of surgery.Blood pressure of every patient was recorded before surgery,during surgery and at1 h,2h,4h,8h,12 h post-surgery in two groups.The pain degree of every patients was evaluated by VAS(visual analog scale) in two groups at 1 h,2 h,4 h,8 h,12 h post surgery,while venous blood sample was obtained for measuring the level of P substance and NO(nitric oxide) at 1 h,2 h,4 h,8 h,12 h after surgery,and the adverse reaction of patients was observed after surgery.Results Levels of P substance and NO in group A were significantly lower than those of group B at 1 h,2 h,4 h,8 h,12 h post-surgery(P<0.05);VAS in group A were significantly lower than those in group Batlh,2h,4h,8h,12 h post-surgery(P<0.05).The incidence of nausea and vomiting had no obvious difference between two groups(P>0.05).No marked difference was found in blood pressure between two groups before surgery and during surgery(P>0.05).There was no statistical difference on blood pressure in group A before surgery,during surgery and post-surgery(P>0.05).Blood pressure in group B was higher than that of group A at 1 h,2 h,4 h,8 h,12 h postsurgery(P<0.05).Conclusion Preemptive analgesia using dezocine can effectively ease pain degree of patients undergoing upper limb operation,stabilize patients' post-surgery hemodynam

关 键 词：地佐辛 超前镇痛 P物质 NO 

分 类 号：R614[医药卫生—麻醉学]