摘要
目的观察地佐辛复合舒芬太尼用于腹腔镜胃癌根治术患者术后镇痛的效果和安全性。方法选择择期行腹腔镜胃癌根治术的患者60例，美国麻醉医师协会（ASA）Ⅰ-Ⅱ级，采用随机数字表法分为两组：舒芬太尼组30例（S组），地佐辛复合舒芬太尼组30例（DS组），两组患者均采用静吸复合全麻的麻醉方法。两组患者术毕清醒后均采用自控静脉镇痛（PCIA）模式，镇痛泵背景速度2ml／h，负荷剂量0．5ml，锁定时间15min。S组采用舒芬太尼3μg／kg＋帕洛诺司琼0．5mg，加入生理盐水至100ml；DS组采用舒芬太尼1．5μg/kg＋地佐辛0．3mg／kg＋帕洛诺司琼0．5mg，加入生理盐水至100ml。观察两组患者术后2h（T1）、6h（T2）、12h（T3）、24h（T4）、48h（T5）时的视觉模拟评分（VAS）、布氏舒适评分（BCS）、镇静程度评分（Ramsay）及不良反应的情况。结果两组患者各时点的VAS、BCS评分比较差异均无统计学意义（P〉0．05）；与术后T1、T2、T3时点比较，两组T4、T5时的Ramsay评分明显降低，差异有统计学意义（P〈0．05）；S组术后T1、T2、T3时的Ramsay评分明显高于DS组，差异有统计学意义（P〈0．05）；DS组患者术后镇痛期间恶心呕吐、嗜睡的发生率明显低于S组，差异有统计学意义（P〈0．05）。结论地佐辛复合舒芬太尼用于胃癌术后镇痛能获得满意效果，较单纯应用舒芬太尼不良反应更小。
Objective To investigate the analgesic efficacy and safety of decozine combined with sufentanil on patients after laparoscopic radical gastrectomy. Methods Sixty patients undergoing laparo- scopic radical gastrectomy, American Society of Anesthesiologists （ASA） Ⅰ-Ⅱ, were selected, and were randomly divided into two groups. All of the patients were treated with intravenous-inhalation combined an- esthesia, and was given patient controlled intraveous analgesia （PCIA） when the patient was awoken. PCIA was administered with subsequent bolus of 0. 5 ml with lockout time 15 minutes and background infusion of 2 ml/h. A ratio （3 μg/kg） of sufentanil and 0. 5 mg palonosetron were mixed in PCIA pump in sufentanil group （S group） ; and 1.5μg/kg sufentanil, 0. 3 mg/kg dezocine, and 0. 5 mg palonosetron in PCIA were mixed in dezocine combined with sufentainl group （DS group）, they were diluted to 100 ml with saline. The visual analogue scale （VAS） , Bruggrmann comfort scale （BCS）, Ramsay and incidence of adverse re- actions of two groups were observed in 2 h （T1 ）, 6 h （ T2 ）, 12 h （T3 ）, 24 h （ T4 ）, 48 h（T5 ） after opera- tion. Results There was no significant difference of VAS and BCS between two groups at each time point after operation （ P 〉 0. 05 ） ;The Ramsay score of S group was significantly higher than that of DS group at T1, T2, and T3 （P 〈 0. 05）. The Ramsay scores of two groups at T4, T5 were lower than those of T1 , T2, and T3. The incidence of nausea, vomiting of DS group was significantly lower than that of S group （ P 〈 0. 05）. Conclusions Dezocine combined with sufentainl used in PCIA on postoperative gastric cancer patients can obtain satisfactory analgesic effects, but has fewer side effects than single sufentainl.
作者
郭智星
孙莉
Guo Zhixing Sun Li(Department of Anesthesiology, Cancer Hospital of Chinese Academy of Medical Sciences, Belting 100021, China)
出处
《中国医师杂志》
CAS
2017年第1期69-71,共3页
Journal of Chinese Physician
