地佐辛与布托啡诺用于妇科手术后PCIA效果的对照研究

目的探讨地佐辛与布托啡诺用于妇科手术后静脉自控镇痛(PCIA)的效果和不良反应的发生情况。方法 80例妇科手术患者随机分为4组,每组20例,四组病例PCIA的镇痛药液分别选用:A组地佐辛0.8 mg/kg,B组地佐辛0.4 mg/kg加高乌甲素32 mg,C组布托啡诺8 mg,D组布托啡诺5 mg加高乌甲素32 mg等进行镇痛。观察术后1、6、12、24、36、48h生命体征监测指标和不良反应的发生情况,并进行双盲镇痛、舒适度和镇静评分。结果术后1 h、6 h,地佐辛组VAS评分明显低于布托啡诺组(P<0.05);术后1 h、6 h、12 h、24 h,地佐辛+高乌甲素组VAS评分明显低于布托啡诺+高乌甲素组(P<0.05)。地佐辛+高乌甲素组镇痛效果优于布托啡诺+高乌甲素组。术后1 h、6 h、12 h,地佐辛组BCS分级明显高于布托啡诺组(P<0.05),地佐辛+高乌甲素组BCS分级明显高于布托啡诺+高乌甲素组(P<0.05)。术后24 h、36 h、48 h,地佐辛+高乌甲素组BCS分级明显高于布托啡诺+高乌甲素组(P<0.05)。结论地佐辛较布托啡诺镇痛作用更强、镇痛效果更好、舒适度更佳。妇科手术后PCIA应首选地佐辛进行镇痛。

A contrastive study on dezocine and butorphanol in patient- controlled intravenous analgesia (PCIA) after gynecological surgery

Objective To explore the dezocine and butorphanol in patient-controlled intravenous analgesia(PCIA) after gynecological surgery.Methods Eighty patients with gynecological surgery were randomly divided into 4 groups with 20 each.PCIA analgesic liquids were chosen as follows: group A with dezocine 0.8 mg/kg,group B with dezocine 0.4 mg/kg and lappaconitine 32 mg,group C with butorphanol 8 mg,group D with butorphanol of solutia 5 mg added to lappaconitine 32 mg.The monitoring indices of vital signs and adverse reactions were observed 1h,6h,12h,24h,36h and 48 h after operation.The double-blind analgesia,comfortableness,and sedation scores were conducted.Results The VAS score of the dezocine group was significantly lower than that of the butorphanol group 1h and 6h after operation(P<0.05).The VAS score of dezocine+lappaconitine group was significantly lower than that of the butorphanol+lappaconitine group 1 h,6 h,12 h,24 h after operation(P<0.05).The analgesic effect of dezocine+lappaconitine group was better than that of the butorphanol+lappaconitine group.The BCS classification of the dezocine group was significantly higher than that of the butorphanol group 1 h,6 h,12 h after operation(P<0.05).The BCS classification of the dezocine+lappaconitine group was significantly higher than that of the butorphanol+lappaconitine group(P<0.05).The BCS classification of the dezocine+lappaconitine group was significantly higher than that of the butorphanol+lappaconitine group 24 h,36h,48h after operation(P<0.05).Conclusion Compared with butorphanol,dezocine has stronger effect of analgesia and better comfort effect.After gynecological surgery,dezocine should be the first choice as analgesia for PCIA.