不同剂量喷他佐辛用于乳腺癌术后自控镇痛的效果比较

目的 比较不同剂量喷他佐辛用于乳腺癌患者术后静脉镇痛的临床效果和安全性,以探讨合适的镇痛剂量.方法 选择乳腺癌手术患者90例(ASAⅠ～Ⅱ级),随机分为三组,每组30例,P1组喷他佐辛术后镇痛剂量为0.04 mg/(kg·h),P2组为0.05 mg/(kg·h),P3组为0.06 mg/(kg·h).分别于术后4、12、24、48 h记录视觉模拟评分(VAS评分)、Prince-Henry评分、镇静评分、平均动脉压(MAP)、心率(HR)、呼吸频率(RR)、脉搏氧饱和度(SpO2).并于48 h后记录镇痛总体满意度评分和不良反应(恶心、呕吐、皮肤瘙痒).结果 P1组各时间点的VAS评分与P2、P3组比较差异有统计学意义(P<0.05);P1组4、12、24 h的Prince-Henry评分与P2、P3组比较差异有统计学意义(P<0.05);P3组4 h的镇静评分与P1组比较差异有统计学意义(P<0.05);P3组4 h的RR与P1、P2组比较差异有统计学意义(P<0.05);P1组的镇痛满意度评分与P2、P3组比较差异有统计学意义(P<0.05),P2组与P3组比较差异无统计学意义(P>0.05).结论 乳腺癌患者术后静脉持续输注0.05 mg/(kg·h)喷他佐辛,可提供较好的镇痛效果,且不良反应少.Abstract：Objective To compare the clinical effect and safety of different dose of pentazocine for postoperative patient-controlled intravenous analgesia after resection of breast cancer. Methods A total of 90 patients of ASAⅠ-Ⅱundergoing resection of breast cancer were randomly divided into 3 groups(n=30/group). Group P1 was administered with continuously intravenous pentazocine at 0.04 mg/(kg·h) after operation, group P2 pentazocine 0.05 mg/(kg·h) and group P3 pentazocine 0.06 mg/(kg·h).Visual analogue scale(VAS), Prince-Henry, sedation scores and vital signs(MAP, HR, RR, SpO2) were assessed after 4,12,24,48 hours of postoperative analgesia. The scores of satisfaction of postoperative analgesia and the adverse reactions including nausea, emesis, pruritus and resperitory inhibition were recorded after 48 hours of postoperative analgesia.Results After 4,12,24 and 48 hours of postoperative analgesia, VAS scores were higher in group P1 than that in group P2 and group P3(P<0.05).After 4,12 and 24 hours of postoperative analgesia, Prince-Henry scores were higher in group P1 than that in group P2 and group P3(P<0.05).After 4 hours of postoperative analgesia, sedation scores were higher in group P3 than that in group P1(P<0.05).After 4 hours of postoperative analgesia, RR was slower in group P3 than that in group P1 and group P2(P<0.05). The scores of satisfaction of postoperative analgesia were higher in group P1 than that in group P2 and group P3(P<0.05), there was no significantly difference in group P2 and group P3(P>0.05).Conclusions Pentazocine 0.05 mg/(kg·h) for postoperative analgesia after resection of breast cancer provides better analgesia effect and few adverse reaction.

Different dose of pentazocine for postoerative patient-controlled intravenous analgesia after resection of breast cancer

Breast cancer Pentazocine Postoperative analgesia