摘要
目的观察不同时间点应用地佐辛对上腹部手术患者术后镇痛效果的影响。方法 100例择期行上腹部手术的患者,随机分为4组,每组各25例,A组为对照组,B、C和D组分别于切皮前、缝皮时、切皮前和缝皮时静脉各给予地佐辛5 mg。术毕4组开启同样配方的静脉自控镇痛泵。分别记录患者术毕拔除气管导管术后1 h(T1)、4 h(T2)、8 h(T3)、12 h(T4)、24h(T5)、48 h(T6)的VAS镇痛评分、Ramesay镇静评分、术后24 h内患者PCA按压次数及不良反应。结果 B、C和D组在T1、T2、T3、T4时间点的VAS评分均低于A组(P<0.05),在T1、T2、T3时间点的Ramesay评分均高于A组(P<0.05);D组在T1、T2、T3、T4时间点的VAS评分均显著低于B、C组(P<0.05),在T1、T2、T3时间点的Ramesay评分均高于B、C组(P<0.05)。B、C、D组患者在术后24 h内的PCIA泵按压次数均低于A组(P<0.05),D组患者在术后24 h内PCIA按压次数均显著低于B、C组(P<0.05),而恶心、呕吐、皮肤瘙痒及呼吸抑制等不良反应组间差异无统计学意义。结论地佐辛有较强的镇痛作用,上腹部手术于手术切皮前和缝皮时均静脉给药,术后的镇痛效果佳。
Objective To observe the analgesic effect of dezocine used at different time points in patients undergoing upper abdomen surgery. Methods One hundred patients of upper abdomen surgery were randomly divided into four groups（25 patients in each group）. Group A was the control group. Group B was given 5 mg dezocine intravenously before incising the skin. Group C was given 5 mg dezocine intravenously before suturing the skin. Group D was given 5 mg dezocine intravenously both before incising and suturing the skin. All the four groups received the same patient controlled intravenous analgesia（PCIA）. VAS pain score and Ramesay sedation score were recorded at 1 h（T1）, 4 h（T2）, 8 h（T3）, 12 h（T4）, 24 h（T5）, 48 h（T6） after operation, the pressing times of PCIA and adverse reactions were also recorded at 24 h after operation. Results VAS scores of group B, C and D were lower than those of group A at T1、 T2、T3 and T4（P〈0.05）. Ramesay scores of group B, C and D were higher than group A at T1, T2 and T3（P〈0.05）; While VAS scores of group D were lower than those of group B and C at T1、T2、T3 and T4（P〈0.05）. Ramesay scores of group D were higher than group B and C at T1、T2 and T3（P0.05）. The times of the PCIA 24 h after operation in group A were more than group B、C and D（P〈0.05）, and D group were less than group B and C（P〈0.05）.While nausea, vomiting, pruritus and respiratory depression and other adverse reactions showed no significant difference. Conclusion Dezocine has a strong analgesic effect. Before surgical incision and by skin closure time dezocine administered intravenously is the best upper abdomen surgery postoperative analgesia.
出处
《世界临床药物》
CAS
2014年第5期291-294,共4页
World Clinical Drug
关键词
地佐辛
上腹部手术
患者静脉自控镇痛
dezocine
upper abdomen surgery
patient-controlled intravenous analgesia
