地佐辛复合氟比洛芬酯用于上腹部手术术后镇痛的多中心临床研究

目的观察地佐辛联合氟比洛芬酯用于上腹部手术术后镇痛的有效性及安全性。方法本研究为多中心、前瞻、随机、单盲和对照临床研究。择期行上腹部手术患者216例,ASAⅠ或Ⅱ级,计算机信封法随机均分为地佐辛组(D组)和舒芬太尼组(S组)。D组于手术结束前30 min缓慢静注地佐辛5 mg+氟比洛芬酯50 mg,继之用生理盐水将地佐辛25 mg+氟比洛芬酯250 mg配制成100 ml,以2 ml/h的速率持续静脉输注48 h;S组于手术结束前30min缓慢推注舒芬太尼3μg,此后用生理盐水将3μg/kg的舒芬太尼配制成100 ml持续泵注。分别记录患者术后1、4、8、12、24、36、48 h安静和90°翻身活动时的疼痛VAS评分、Ramsay镇静评分、镇痛泵按压次数、副作用等。结果两组术后各时点安静状态VAS评分及Ramsay镇静评分差异均无统计学意义,90°翻身活动时D组各时点VAS评分均低于S组(P<0.05)。出汗、恶心和寒战发生率D组明显低于S组(P<0.05)。结论与单用舒芬太尼比较,地佐辛联合氟比洛芬酯对术后运动痛有较好的疗效,且副作用少。

Clinical observation of dezocine combined with flurbiprofen for postoperative analgesia after abdominal surgeries: a prospective study

Objective To investigate the effects of dezocine combined with flurbiprofen for postoperative analgesia after abdominal surgeries.Methods This was a multi-center,prospective, single-blind and controlled clinical study.Two hundred and sixteen patients scheduled for selective upper-abdominal operation were randomly divided into dezocine group(group D) and sufentanil group (group S).Thirty minutes before the end of operation,patients in group D were given 5 mg dezocine and 50 mg flurbiprofen,and then an intravenous pump containing 25 mg dezocine and 250 mg flurbiprofen in a volume of 100 ml was administered at the speed of 2 ml/h for 48 h after operation. For patients in group S,3μg sufentanil were administered before the end of operation and then 3μg/kg sufentanil for continuous infusion.Visual analogue score(VAS) during both silence and 90 turn over situation,Ramsay score,and adverse effects at 1,4,8,12,24,36,48 h after the operation were recorded respectively.Results Compared with group S,patients in group D showed no significant difference in the Ramsay score and VAS pain during silence,but a significant decrease in VAS pain under turn-over was observed(P<0.05).Less perspiration,nausea and chill were observed in group D than group S(P<0.05).Also,there was no shivering occurred in group D. Conclusion Administration of dezocine combined with flurbiprofen has a preferable therapeutic effect for post-operative movement pain and less adverse effect as compared to sufentanil alone.