地佐辛超前镇痛对妇科手术患者术后自控镇痛效果的影响

目的 观察术前静脉注射地佐辛对妇科手术患者术后舒芬太尼自控镇痛效果的影响.方法 80例全身麻醉下行妇科下腹部手术患者,年龄28～68岁,身高147～175 cm,体重40～76 kg,ASA分级Ⅰ或Ⅱ级.随机分为两组(n = 40):舒芬太尼组(S组)切皮前30 min静脉注射生理盐水2 ml;地佐辛联合舒芬太尼组(DS组)切皮前30 min静脉注射地佐辛5 mg(生理盐水稀释至2 ml).均采用气管插管全凭静脉麻醉,术后行PCIA.PCIA配方是:舒芬太尼2.5 μg/kg+盐酸昂丹司琼0.2 mg/kg加生理盐水稀释至100 ml.维持VAS评分≤3分.于术后4、12、24、48 h观察患者视觉模拟评分(VAS)、镇静程度评分(Ramesy)、48 h内患者自控镇痛(Patientcontrolledanalgesia,PCA)按压次数、患者总体满意度及不良反应的情况.结果 两组配方均能为患者提供良好的术后镇痛,患者总的PCA按压次数差异无统计学意义.DS组患者的VAS评分、Ramesy镇静评分及患者术后的总体满意度显著优于S组(P<0.05),且不良反应更少.结论 术前静脉注射地佐辛5 mg地佐辛联合舒芬太尼自控镇痛用于妇科手术,镇痛效果确切可靠且不良反应少.

Effect of intravenous injection of dezocine pre-emptive analgesia on efficacy of postoperative analgesia in patients undergoing gynaecological surgery

Objective To assess the influence of intravenous injection of dezocine before operation on efficacy of postoperative analgesia in patients undergoing gynaecological surgery.Methods Eighty ASAⅠorⅡpatients,aged 28~68yr,weighing40~76 kg,scheduled for gynaecological surgery under general anesthesia were randomly allocated into 2 groups（n = 40）：group S and DS.Patients in Group S received iv injection of normal saline（2 ml） 30 min before skin incision.Patients in Group DS received iv injection of sodium dezocine 5 mg 30 min before skin incision.The patients received patient-controlled intravenous analgesia（PCIA）with：sufentanil2.5 μg/kg＋ Ondansetron 0.2 mg/kg.The VAS score was maintained ≤ 3,VAS,Ramesy scores and pressing times of PCA equipment,Side effects as well as patien satisfactory degree were recorded and compared 4,12,24 and 48 h after operation.Results There was no significant difference in pressing times of PCA equipment.But DS group showed better outcomes regarding to the VAS score,Ramesy score,and patient’s satisfactory degree comparing with group S（P〈0.05）.There was no significance difference in side effects between 2 groups（P〉0.05）.Conclusion Intravenous injection of dezocine 5 mg before operation reduces the perioperative fentanyl consumption in patients undergoing gynaecological surgery.Decozine combining with sufentanyl in PCIA exhibits better anaglgesia effect with less side effects,and it’s worth for clinical application.