地佐辛用于腹腔镜胆囊切除术患者术后镇痛的临床观察

目的观察腹腔镜胆囊切除患者术后单次使用地佐辛镇痛的临床效果。方法择期在全麻下行腹腔镜胆囊切除术的患者240例，ASAⅠ-Ⅱ级，随机分为3组，各组均在术毕静脉注射地佐辛5mg（A组，n=80）、地佐辛10mg（B组，n=80），对照组给予芬太尼1μg/kg（C组，n=80）。观察各组拔管时患者平均动脉压（MAP）、心率（HR），术后1h、4h、6h、8h的VAS评分，并记录各组患者要求再次镇痛的间隔时间与总次数及不良反应。结果拔管时血流动力学指标比较各组差异无显著性（P〉0．05）；术后8h内VAS评分B组明显低于A组和C组（P〈0．05）；术后要求再次镇痛的间隔时间与总次数B组次数最少，间隔时间最长（P〈0．01）。结论腹腔镜胆囊切除术患者术毕静脉注射地佐辛5mg、10mg可有效缓解术后急性疼痛，10mg镇痛作用更强，不良反应少，值得临床推广。

Effect of Dezocine for Postoperative Analgesia in Patients after Laparoscopic Cholecystectomy

Objective To observe the postoperative analgesic effect of dezocine in patients with single intravenous injection undergoing laparoscopic cholecystectomy. Methods Two hundred fourty patients （ ASA physical status 1 or 2 ）scheduled for elective Laparoscopic Cholecystectomy under general anesthesia were randomly divided into 3 groups of 80 each ： group A （ dezocine 5 mg）, group B （ dezocine 10mg） and group C （ fentanyl 1 μg/kg）. dezocine was injected before the end of operation in group A and group B. observe the hemodynamic parameters of extubation time, and the VAS pain score at 1,4,6,8h after end of surgery, Records The interval time and the total number of injecting analgesic that patients requested again, and adverse reactions. Results There were no statistical significance of hemodynamic parameters of extubation（ P 〉0.05 ） ;During the first 8 postoperative hours,VAS scores of B group were significantly lower than those of groups A and C （P 〈 0.05） ;The longest interval between the least number of B group （P 〈 0.05） ; Conclusion Dezocine 5 mg or dezocine 10 mg injected before the end of Laparoscopic Cholecystectomy provide satifactory postoperative pain relief, the analgesic action of dezocine 10 mg is better, and safe with less side effect in the patients undergoing laparoscopic cholecystectomy,it deserve clinical application.