地佐辛联合舒芬太尼用于剖宫产静脉镇痛的临床效果观察

目的 评价地佐辛联合舒芬太尼用于剖宫产术后静脉镇痛的效果及不良反应.方法 选择120例美国麻醉医师协会(ASA)Ⅰ～Ⅱ级在腰硬联合麻醉下行剖宫产患者,完全随机分为地佐辛、舒芬太尼组(DF组)及单纯舒芬太尼组(F组)各60例.2组术毕前10 min硬膜外注入吗啡1～2 mg为负荷量,随后接静脉镇痛泵.DF组:地佐辛10 mg+舒芬太尼100 μg+托烷司琼5 mg +0.9％氯化钠注射液至100 ml;F组:舒芬太尼200 μg+托烷司琼5 mg +0.9％氯化钠注射液至100ml.观察并记录术后48 h内视觉模拟疼痛(VAS)评分、RSS镇静评分及不良反应.结果 2组术后镇痛效果VAS组内、组间比较差异无统计学意义(P ＞0.05)；RSS镇静评分,术后3、6、12、24 h DF组明显高于F组(3.5±0.7)分比(2.4±0.6)分,(3.5±0.7)分比(2.3±0.8)分,(3.3±0.7)分比(2.3±0.7)分,(3.5±0.8)分比(2.5±0.5)分,均P＜0.05]；不良反应发生率,DF组明显低于F组15.0％(9/60)比53.3％(32/60),P＜0.05].结论 地佐辛0.2 mg/kg联合舒芬太尼2 μg/kg镇痛效果相当于舒芬太尼4μg/kg,不良反应发生率低于单用舒芬太尼.

Clinical investigation of dezocine combined with sufentanil for intravenous analgesia in cesarean section

Objective To evaluate the effects of postoperative intravenous analgesia with dezocine combined with sufentanil in cesarean section. Methods One hundred and twenty patients of society of anesthesiologists（ASA） Ⅰ-Ⅱ level were randomly divided into group DF （dozincine combined with sufentail） and group F （sufentail）. Ten minutes before the surgery was finished, morphia （1-2 mg as loading dose） was injected into epidural. Patients in group DF were given docozine 10 mg ＋ sufentanil 100 μg ＋ tropisetron 5 mg ＋ 0. 9% NaC1 ; patients in group F were given sufentanil 200 p.g＋ tropisetron 5 mg ＋ 0. 9% NaC1. Visual analogue scale（ VAS）, Ramsay Sedation Scale（RSS） and side effects were observed and recorded 48 hours after surgery. Results There were no significant differences in VAS between two groups （ P 〉 0. 05 ）. The scores of RSS in group DF were higher than those in group F 1,3,6,12,24 hours after surgery. The rate of side effects was lower in group DF than that in group F15.0% （9/60） vs 53.3% （32/60） ,P 〈0.05]. Conclusion The effect of analgesia with dezocine 0. 2 mg/kg combined with sufentanil 2 μg/kg is equal to that of sufentanil, and the rate of side effect is lower than that of sufentanil.