地佐辛联合舒芬太尼用于术后自控静脉镇痛效果观察

目的:观察地佐辛联合舒芬太尼用于腹部手术术后自控静脉镇痛(Patient controlled intraveous analge-sia,PCIA)的效果。方法:选择ASAⅠ～Ⅱ级择期行腹部手术的患者90例,均采用气管插管全凭静脉麻醉,术后行PCIA。患者随机分为地佐辛组(D组)、舒芬太尼组(S组)、地佐辛联合舒芬太尼组(DS组),每组30例。3组PCIA配方分别是:(1)D组:地佐辛0.8 mg/kg+盐酸昂丹司琼0.2 mg/kg加生理盐水稀释至100 mL;(2)S组:舒芬太尼2.5 ug/kg+盐酸昂丹司琼0.2 mg/kg加生理盐水稀释至100 mL;(3)DS组:地佐辛0.3 mg/kg+舒芬太尼1 ug/kg+盐酸昂丹司琼0.2 mg/kg加生理盐水稀释至100 mL。观察3组患者术后2、6、12、24、48 h视觉模拟评分(VAS)、镇静程度评分(Ramesy)、48 h内患者自控镇痛(Patient controlled analgesia,PCA)按压次数、患者总体满意度及不良反应的情况。结果:3组配方均能为患者提供良好的术后镇痛,3组患者总的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D组和S组(P<0.05),且不良反应更少。结论:地佐辛联合舒芬太尼用于腹部手术PCIA,镇痛效果确切可靠且不良反应少,可用于临床PCIA。

Anagesia effects of docozine combining sufentanil in PCIA

Objective：To evaluate the anagesia effects of PCIA with docozine and sufentanil in abdominal operation.Methods：Ninety patients with ASA Ⅰ～Ⅱ that were scheduled for abdominal operation under intravenous analgesia with tube insertion and treated with PCIA after the operation were selected and divided into decozine group（Group D,n=30）,sufentanil group（Group S,n=30）,and decozine combining sufentanil group（Group DS,n=30）.PCIA gradients used for group D,Group S and group DS was decozine 0.8 μg/kg＋ Ondansetron HCL 0.2 mg/kg;sufentanil 2.5μg/kg＋ Ondansetron HCL 0.2 mg/kg;and decozine 0.3 mg/kg＋sufentanil 1 μg/kg＋ Ondansetron HCL 0.2 mg/kg,seperately;which were diluted to be 100 mL by adding saline.VAS,Ramesy scores and pressing times of PCA equipment,side effects as well as patient＇s satisfactory degree were recorded and compared.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 D and group S（P0.05）.Group DS also showed less side effects.Conclusion：Decozine combining with sufentanyl in PCIA exhibits better anaglgesia effect with less side effects,and it＇s worth for clinical application.