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不同剂量纳洛酮联合地佐辛用于乳腺癌患者术后镇痛的效果
引用本文:李莹,宋振国,张广华. 不同剂量纳洛酮联合地佐辛用于乳腺癌患者术后镇痛的效果[J]. 中国肿瘤临床, 2019, 46(2): 86-89. DOI: 10.3969/j.issn.1000-8179.2019.02.150
作者姓名:李莹  宋振国  张广华
作者单位:天津医科大学肿瘤医院麻醉科,国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室,天津市恶性肿瘤临床医学研究中心(天津市300060)
摘    要:目的:评价不同剂量纳洛酮联合地佐辛用于乳腺癌患者术后镇痛的效果。方法:选取2018年5月至2019年1月天津医科大学肿瘤医院120例行乳腺癌改良根治术患者的临床资料,随机分为L、M、H、C组(n=30)。各组均给予地佐辛0.15 mg/kg,L、M、H组分别给予纳洛酮0.5、1.0、1.5μg/kg,C组给予等容量生理盐水。分别记录患者苏醒及拔除喉罩时间,喉罩拔除期间的血压、心率,术后1 h(T1)、6 h(T2)、12 h(T3)、24 h(T4)的视觉模拟评分(VAS)、舒适评分(BCS)、Ramsay评分,术后补救镇痛及不良反应次数。结果:L、M、H组的苏醒及拔除喉罩时间短于C组,M组苏醒时间最短(P<0.05)。T1、T2、T3时M组VAS评分低于其他3组(P<0.05),C组术后补救镇痛及不良反应次数多于其他3组(P<0.05)。结论:纳洛酮1.0μg/kg联合地佐辛(0.15 mg/kg)可增强地佐辛术后镇痛效果,缩短苏醒时间,减少不良反应。

关 键 词:地佐辛  纳洛酮  术后镇痛  乳腺癌  不良反应
收稿时间:2019-01-07

Effect of different doses of naloxone combined with dezocine on postoperative analgesia in patients with breast cancer
Ying Li,Zhenguo Song,Guanghua Zhang. Effect of different doses of naloxone combined with dezocine on postoperative analgesia in patients with breast cancer[J]. Chinese Journal of Clinical Oncology, 2019, 46(2): 86-89. DOI: 10.3969/j.issn.1000-8179.2019.02.150
Authors:Ying Li  Zhenguo Song  Guanghua Zhang
Affiliation:Department of Anesthesiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
Abstract:  Objective  To evaluate the effects of different doses of naloxone combined with dezocine on postoperative analgesia in patients with breast cancer.  Methods  One hundred and twenty patients with modified radical mastectomy were enrolled in the Tianjin Medical University Cancer Institute and Hospital, between May 2018 and January 2019. The patients were randomly assigned into group L, group M, group H, and group C (n=30). Patients in each group were administered 0.15 mg/kg of dezocine. Patients in group L, group M, and group H were intravenously instilled with naloxone (0.5, 1.0, and 1.5μg/kg, respectively), while patients in group C were administered equal volumes of normal saline. We recorded the time of awakening and removing the laryngeal mask in each group, and the blood pressure and heart rate of each patient around the time of removing the laryngeal mask. We determined the visual analog scale (VAS) scores of pain, Bruggrmann comfort scale (BCS) scores, and Ramsay sedation scores at 1h (T1), 6h(T2), 12h (T3), and 24h (T4) postoperatively, and the number of remedial analgesia and postoperative adverse reactions were recorded in each group after surgery.  Results  The time of awakening and removing the laryngeal mask in group L, group M, and group H were shorter than that in group C, and group M had the shortest awakening time (P < 0.05). The VAS scores of the patients in group M at T1, T2, and T3 were lower than those in the other three groups (P < 0.05). The number of postoperative remedial analgesia and adverse reactions in group C were higher than those in the other three groups (P < 0.05).  Conclusions  Naloxone (1.0 μg/kg) combined with dezocine (0.15 mg/kg) can enhance the postoperative analgesic effect of dezocine, shorten the awakening time, and reduce the adverse reactions. 
Keywords:dezocine  naloxone  postoperative analgesia  breast cancer  adverse reaction
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