地佐辛用于瑞芬太尼麻醉下乳腺区段切除术后镇痛的观察

目的评估地佐辛用于瑞芬太尼麻醉下乳腺区段切除术后镇痛的有效性和安全性。方法 120例择期在瑞芬太尼麻醉下行乳腺区段切除术的患者,随机分为4组,分别接受芬太尼1μg/kg(F组),地佐辛50μg/kg(D1组)、100μg/kg(D2组)和150μg/kg(D3组)静脉镇痛治疗。记录各组手术后苏醒时间,苏醒后0、1、2、4、6h的疼痛及镇静评分,苏醒后6h内要求补充镇痛的例数及不良反应情况。结果 F组和D3组的苏醒时间明显长于D1和D2组(P<0.05);苏醒时F、D2、D3组的疼痛评分无明显差别,均大于D1组(P<0.05),但F组的疼痛评分在1h后明显增高;F和D1组需要补充镇痛的例数明显高于其他两组(P<0.05);呼吸抑制、恶心呕吐等不良反应F组最多,D3组次之。结论 100μg/kg地佐辛静脉滴注能安全有效地用于瑞芬太尼麻醉下乳腺区段切除术后镇痛。

Observation of postoperative analgesia with dezocine intravenous injection for regional mastectomy with remifentanil anesthesia

Objective To evaluate the efficacy and safety of intravenous infusion of dezocine for postoperative analgesia in patients undergoing regional mastectomy surgery with remifentanil anesthesia, and determine the suitable dosage of dezoeine. Methods A total of 120 patients undergoing regional masteetomy surgery with remifentanil anesthesia were randomly divided in- to four groups, i. e. Group F （fentanyl 1 μg/kg）, Group D1 （dezocine 50μg/kg）, Group D2 （dezocine 100 μg/kg）, Group D3 （dezocine 150 μg/kg）, to accept intravenous infusion before 10 min of the end of surgery for postoperative analgesia. Time of recovery, pain and sedation scores at 0, 1, 2, 4, 6 h afteranalepsia, requirements of analgesia in 6 h fromanalepsia, the inci- dence of side-effect including respiratory depression, nausea and vomiting were recorded. Results The awake time of group F and D3 were significantly longer than that of group D1 and D2 （P〈0.05）, and there was no significant difference between group D1 and group D2 （P〉0.05）. At the moment of analepsia, the pain score of D1 was significantly higher than that of group F, D2 and 193 （P〈0.05）, and there was no significantly difference among group F, D2 and D3 （P〉0.05）, neverthe- less, the pain score of group F decreased significantly 1 h later. Even more patients in group F and D1 asked for analgesia （P〈 0.05）. No case with the incidence of respiratory depression, nausea and vomiting was found in group D1 and group D2, and the incidence of respiratory depression, nausea and vomiting were significant higher in group F （P〈0.05）. Conclusion 100μg/kg of dezocine intravenous infusion before 10 min of the end of surgery can be safe and effective for postoperative analgesia in pa- tients undergoing regional mastectomy surgery with remifentanil anesthesia.