结肠癌根治术后地佐辛与舒芬太尼静脉自控镇痛效果比较

目的通过与舒芬太尼比较,探讨地佐辛用于结肠癌根治术后患者静脉自控镇痛(patient controlled intravenousanalgesia,PCIA)的有效性和安全性。方法选择60例剖腹行结肠癌根治术患者,42～70岁,ASAⅠ～Ⅱ级,随机分为地佐辛组(D组),舒芬太尼组(S组),各30例。所有患者选择全身麻醉,手术结束时行PCIA,D组:地佐辛0.8 mg/kg,S组:舒芬太尼2μg/kg,均加入生理盐水稀释至100 ml。两组患者均设置相同镇痛泵参数,监测并记录术后3、6、12、24、48 h VAS镇痛评分、48 h内按压镇痛泵次数、Ramsay镇静评分及不良反应发生情况。结果两组患者术后各时点VAS评分及48 h内按压镇痛泵次数差异无统计学意义(P>0.05),D组患者的Ramsay评分及不良反应发生率均显著低于S组(P<0.05)。结论地佐辛应用于结肠癌根治术后PCIA,镇痛效果确切;较舒芬太尼不良反应发生率低,安全性高,是一种较理想的PCIA药物。

Comparison of patient controlled intravenous analgesia with dezocine and sufentanil following resection of colon cancer

Objective To compare the efficacy and safety of dezocine and sufentanil in patient controlled intravenous analgesia following resection of colon cancer.Methods Sixty patients scheduled for resection of colon cancer,aged 42 to 70,ASAⅠ~Ⅱ,were randomly arranged into dezocine group（group D） and sufentanil group（group S）of 30 patients each.All the patients were given general anesthesia and treated with patient controlled intravenous analgesia（PCIA） towards the end of operation.PCIA gradients used for group D and group S were decozine 0.8 mg/kg and sufentanil 2 μg/kg,respectively,which were diluted to 100 ml by adding saline.VAS,Ramsay scores（3 h,6 h,12 h,24 h,48 h after operation）,pressing times of PCA equipment and adverse effects were recorded and compared.Results There was no significant difference in the VAS scores and pressing times of PCA equipment（P0.05）.The Ramsay scores and adverse effects in group D were significantly lower than those in group S（P0.05）.Conclusions Dezocine in PCIA following resection of colon cancer exhibits good effect of analgesia and minor adverse reactions,which can serve as a safe and more effective method of analgesia.