地佐辛在胸部创伤早期镇痛中的应用

目的观察地佐辛用于胸部创伤患者的早期镇痛效果。方法选择90例胸部创伤患者，完全随机分为3组：地佐辛组、盐酸哌替啶组和酮咯酸氨丁三醇组，分别肌内注射地佐辛10mg、盐酸哌替啶50mg、酮咯酸氨丁三醇60mg，1次／8h。观测3组治疗6、12、24h后的血压、心率，呼吸频率，监测脉搏血氧饱和度（SpO2）、PaO2及PaCO2值以及用药后2、4、8、12、24h各组VAS评分、BCS评分和用药后不良反应。结果治疗后6、12、24h血压、心率和PaO2、PaCO2地佐辛组和盐酸哌替啶组与酮咯酸氨丁三醇组差异有统计学意义（P〈0．05）。地佐辛组与盐酸哌替啶组患者在用药后2、4、8、12、24h各时间点的VAS评分低于酮洛酸氨丁三醇组，BCS评分高于酮咯酸氨丁三醇组，差异有统计学意义（P〈0．05）。地佐辛组患者用药后的不良反应总发生率低于盐酸哌替啶组、酮咯酸氨丁三醇组[13．0％（4／30）比43．0％（12／30）、27．0％（8／30）]（P〈0．05）。结论地佐辛在胸部创伤早期镇痛中的效果与盐酸哌替啶相当，优于酮咯酸氨丁三醇，但较盐酸哌替啶和酮咯酸氨丁三醇不良反应发生率低，其镇痛效果确切，安全性高。

Effect of dezocine on the analgesia in early stage of chest trauma

Objective To observe the effect of dezoeine on the analgesia in early stage of chest trauma. Methods A total of 90 patients with chest trauma were randomly divided into three groups：group A （dezocine group）, group B （pethidine group）and group C （ketorolac tromethamine group）. Each patient accepted tntramuscular injection 10 mg of dezocine for group A, 50 mg of pethidine hydrochloride for group B, and 60 mg of ketorolac tromethamine for group C, every 8 hours, respectively. Then the blood pressure, heart rate, breathing rate, pulse blood oxygen saturation （ SpO2 ） , PaO2 and PaCO2 of each patient were detected after treatment for 6, 12 and 24 h. The visual analogue scale （VAS） , bruggr mann comfort scale（BCS） scores and adverse reactions were also evalua- ted after 2, 4, 8, 12 and 24 h. Results After treatment 6, 12, 24 h blood pressure, heart rate and the Pa02, PaCO2 in dezocine had statistically significant difference compared with pethidine hydrochloride group and ketone luo acid tromethamine group （P 〈0.05）. After medication 2, 4, 8, 12, 24 h time point of VAS score, BCS scores in dezocine and pethidine hydrochloride group patients had statistically significant difference compared with ketone luo acid tromethamine group （ P 〈 0.05 ）. Dezocine group had lower incidence rate of total adverse reaction than ketone of pethidine hydrochloride and luo acid tromethamine group [ 13.0% （4/30） vs 43.0% （ 12/30 ）, 27.0% （8/30） ] （P 〈 0.05 ）. Conclusions In early stage of chest trauma, dezocine has the similar analgesia effect with pethidine hydrochloride, and better than that of ketorolac tromethamine. It is an ideal way freafing chest trauma in early stage with little adverse reaction and high safety.