地佐辛与芬太尼用于悬雍垂腭咽成形术后镇痛的评价

目的:探讨地佐辛与芬太尼用于悬雍垂腭咽成形术(UPPP)术后患者行静脉自控镇痛(PCIA)的有效性及安全性。方法:40例择期行UPPP的阻塞性睡眠呼吸暂停综合征患者,随机分为芬太尼组(F组)和地佐辛组(D组),每组20例。UPPP术后行PCIA,观察患者术后1、3、6、12、24h时的镇痛效果。结果:2组患者均镇痛良好。F组术后1h镇痛效果好于D组,但存在镇静过度(P<0.05),其余时间点2组差异无统计学意义(P>0.05)。2组患者PCIA按压次数差异无统计学意义(P>0.05)。F组术后1～3h平均动脉压、心率和术后1h脉搏血氧饱和度低于D组(P<0.05或P<0.01)。F组恶心呕吐及呼吸抑制发生率高于D组(P<0.05),其余不良反应2组差异无统计学意义(P>0.05)。结论:地佐辛应用于阻塞性睡眠呼吸暂停综合征患者UPPP术后PCIA效果确切,较芬太尼更为安全。

The Evaluation of Postoperative Analgesia of Dezocine and Fentanyl in Patients with Uvulopalatopharyngiplasty Surgery

Objective:To evaluate the efficiency and safety of patient-controlled analgesia(PCIA) with dezocine and fentanyl after uvulopalatopharyngiplasty(UPPP) surgery.Methods:Forty patients underwent UPPP surgery for PCIA were randomly divided into two groups:group F(fentanyl 16 μg/kg,n=20) and group D(dezocine 0.8 mg/kg,n=20).Postoperative analgesia was assessed 1 h,3 h,6 h,12 h and 24 h after operation.Results:Patients in both groups showed similar results in pain relief.The analgesic effect was higher 1h after surgery in group F than that of group D,but there was deep sedation(P < 0.05).There were no significant differences in other time points after operation between two groups(P > 0.05).There were no significant differences in PCIA pressing times between two groups(P > 0.05).In group F,mean arterial blood pressure(MAP) and heart rate(HR) were lower at 1-3 h after operation than those of group D(P < 0.05 or P < 0.01).The value of SpO2 was lower 1 h after operation in group F than that of group D(P < 0.01).The incidence of post-operative nausea and vomiting and the incidence of respiratory depression were higher in group F than those of group D(P < 0.05).There were no significant differences in other side effects between two groups(P > 0.05).Conclusion:The patient-controlled intravenous analgesia with dezocine can provide an efficient postoperative analgesia.Comparing with fenatanyl,patient-controlled intravenous analgesia with dezocine is safer after UPPP surgery.