摘要
目的探讨舒芬太尼联合地佐辛在上腹部手术后自控镇痛中的临床效果。方法选择2014年9月至2015年3月在重庆三峡中心医院治疗的上腹部手术患者120例。按照随机数字表法分为观察组和对照组,各60例。观察组选择用舒芬太尼1μg/kg联合地佐辛0.3 mg/kg镇痛,对照组选用舒芬太尼2μg/kg镇痛,所有患者均为持续注射。比较两组患者术后在不同时间段48 h内镇痛情况与镇静情况、24 h自控镇痛次数以及不良反应发生情况。结果两组患者在术后1、6、12 h视觉模拟评分(VAS)镇痛评分呈现上升趋势,术后24、48 h均呈下降低趋势,观察组患者1、6、12、24、48 h VAS评分均显著低于对照组(1.32±0.32比1.76±0.54,2.32±0.65比2.74±0.89,2.82±0.92比3.56±1.12,2.21±0.63比2.90±0.95,1.87±0.60比2.32±0.76)。两组患者在术后1、6、12、24 h镇静评分呈上升趋势,术后48 h均呈下降低趋势,观察组患者术后1、6、12、24、48 h镇静评分情况均低于对照组(1 h:2.32±0.25比2.96±0.62,6 h:2.44±0.32比2.98±0.38,12 h:2.48±0.52比2.88±0.56,24 h:2.56±0.35比3.12±0.54,48 h:2.33±0.16比2.76±0.32)。两组患者在术后1、6、12、24、48 h自控镇痛次数呈下降趋势,观察组患者术后1、6、12、24、48 h镇痛次数均少于对照组(1 h:4.23±1.02比4.51±1.02;6 h:3.75±1.23比3.97±1.21;12 h:2.59±0.65比3.64±0.68;24 h:2.08±0.57比2.44±0.78;48 h:1.79±0.46比2.31±0.62),差异有统计学意义(P<0.05)。观察组不良反应发生率显著低于对照组[10.0%(6/60)比40.0%(24/60)],差异有统计学意义(P<0.05)。结论舒芬太尼联合地佐辛用于上腹部手术后镇痛的效果明显,且不良反应少,安全性高。
Objective To investigate the clinical effect of sufentanil combined with dezocine for patient- coontrolled analgesia after upper abdominal surgery. Methods Total of 120 cases with upper abdominal sur- geryin Sanxia Central Hospital from Mar. 2014 to Mar. 2015 were included in the study and divided into observation group （60 cases） and control group （60 cases） according to random number table method. The control group was treated with sufentanil analgesia 2 μg/kg, and the observation group was given sufentanil by 1 μg/kg combined with dezocine analgesia by 0.3 mg/kg. The 48 hours analgesia situation and sedation situation,24 hours patient-controlled analgesia times and adverse events of the two groups were compared. Results The postoperative 1,6,12 h visual analogue scale （ VAS ） analgesic score of both groups showed a rising trend, than in the dropping trend at 24,48 h after surgery. The pain scores at 1,6,12,24,48 h of the observation group were significantly lower than the control group （ 1.32 ＋ 0. 32 vs 1.76 ± 0. 54,2.32 ± 0. 65 vs 2.74 ± 0. 89,2.82 ± 0. 92 vs 3.56 ± 1.12,2. 21 ± 0. 63 vs 2. 90 ± 0.95,1.87 ± 0.60 vs 2.32 ± 0. 76）. The postoperative 1,6,12,24 h sedation score of both groups showed a rising trend, then declined at the 48 h after surgery. Postoperative sedation scores in the observation group were significantly lower than the control group （1 h：2. 32 ±0.25 vs 2.96 ±0.62,6 h：2.44 ±0.32 vs 2.98 ±0.38,12 h：2.48 ±0.52 vs 2.88 ± 0. 56,24 h ：2.56 ± 0. 35 vs 3.12 ± 0. 54,48 h ：2.33 ± 0. 16 vs 2. 76 ± 0.32）. The 1,6,8,12,24 h patient- controlled analgesia times presented a decreasing trend. The analgesia times at postoperative 1,6,12,24,48 hours of the observation group were significantly less than the control group （ 1 h ： 4. 23 ± 1.02 vs 4.51 ± 1.02,6 h：3.75 ±1.23 vs 3.97 ± 1.21,12 h：2. 59 ±0.65 vs 3.64 ±0.68,24 h：2.08 ±0.57 vs 2.44 ± 0. 78,48 h ： 1.79 ± 0. 46 vs 2.31 ± 0.62 ）, there was statistically significant （ P 〈 0.0
出处
《医学综述》
2016年第9期1824-1826,共3页
Medical Recapitulate
关键词
舒芬太尼
地佐辛
上腹部
自控镇痛
Sufentanil
Dezocine
Upper abdomen
Patient-controlled analgesia
