地佐辛用于痔上粘膜环切术后硬膜外镇痛效果的临床观察

目的:比较地佐辛与芬太尼分别复合罗哌卡因用于痔上粘膜环切术后硬膜外患者自控镇痛时的镇痛效果与不良反应。方法:选择ASAⅠ～Ⅱ级,行痔上粘膜环切手术患者60例,随机分为2组,每组30例。D组:地佐辛10 mg;F组:芬太尼0.4 mg,各组均复合0.125%罗哌卡因加至100 ml硬膜外镇痛。比较2组术后不同时点的视觉模拟评分法(VAS评分)、病人自控性镇痛(patient-controlled analgesia,PCA)泵的患者按压次数(D1)与实际进入次数(D2)以及不良反应的发生率。结果:2组术后各时点的VAS评分及D2/D1比值相比较,差异无统计学意义;F组中有9例出现恶心,7例出现呕吐,与D组相比较,差异有统计学意义(P<0.05)。结论:10 mg的地佐辛复合0.125%罗哌卡因对痔上粘膜环切可达到有效的硬膜外镇痛效果,且不良反应发生率较低,是一种较为安全有效的硬膜外术后镇痛方法。

Clinical observation of patient-controlled epudiral analgesia with dezocine after procedure for prolapse and hemorrhoids

Objective: To observe the analgesia and side-effects of patient-controlled epudiral analgesia(PCEA) dezocine combined with ropivacaine after procedure for prolapse and hemorrhoids.Methods: 60 ASA Ⅰ~Ⅱ patients of procedure for prolapse and hemorrhoids were randomly divided into 2 groups.Each group included 30 patients.Group D: dezocine 10 mg;Group F: fentanyl 0.4 mg,which were combined with 0.125% ropivacaine for epudiral analgesia.The VAS score,the number of patients pushed PCA pumps(D1),the actual entry number(D2) and the ratio of nausea and vomitting were recorded.Results: The VAS score and the ratio of D2/D1 of the 2 groups at each time point were compared,the difference is no significant(P>0.05).The ratio of nausea and vomiting of F group were higher than D group(P<0.05).Conclusion: 10 mg dezocine combined with 0.125%ropivacaine for epudiral analgesia after procedure for prolapse and hemorrhoids is more effective,lower incidence of adverse reactions and a relatively safe and effec-tive technique for epidural analgesia.