地佐辛复合芬太尼在术后静脉镇痛中的临床观察

Cfinical research of Dezocine and Fentanyl combination intravenous injection for postoperative pain

目的评价地佐辛复合芬太尼用于术后静脉镇痛的效果及安全性。方法选择经全麻手术的ASA分级Ⅰ～Ⅱ级的患者60例，按手术先后顺序分为地佐辛一芬太尼组及芬太尼组，每组30例，术毕前10min给予负荷量，地佐辛一芬太尼组静脉注射地佐辛0．1mg／kg，芬太尼组静脉注射芬太尼1μg／kg，术后患者自控镇痛泵配方：地佐辛-芬太尼组为地佐辛0．4mg／kg＋芬太尼8μg/kg＋氟哌利多5mg＋生理盐水至100ml；芬太尼组为芬太尼16μg/kg＋氟哌利多5mg＋生理盐水至100ml。对2组镇痛效果和并发症进行观察并记录。结果地佐辛-芬太尼组术后24、48h镇痛药消耗量和视觉模拟评分（VAS）均低于芬太尼组，术后48h的VAS差异有统计学意义[芬太尼组（2．83±1．42）分，地佐辛-芬太尼组（1．94±1．08）分，P〈0．05]。芬太尼组术后24h镇静评分，2分3例；术后48h镇静评分，2分4例。地佐辛一芬太尼组术后24h镇静评分，2分13例；48h镇静评分，2分15例，3分1例。地佐辛一芬太尼组术后24、48h镇静评分2分及以上的患者数多于芬太尼组，差异有统计学意义（P〈0．05）。芬太尼组术后24h呕吐评分，1分5例；48h，1分8例；地佐辛一芬太尼组术后24h，1分3例；48h，1分1例。地佐辛一芬太尼组呕吐评分1分及以上的患者例数少于芬太尼组，差异有统计学意义（P〈0．05）。结论地佐辛复合芬太尼用于术后静脉镇痛的镇痛效果满意，具有使用剂量小、不良反应较轻等优点。

Objective To evaluate the effect and safety of dezocine and fentanyl combination intravenous injection for postoperative pain. Methods Totally 60 general anaesthesia patients of visual analogue scale （ ASA ） grade Ⅱ or Ⅱ were randomly into two groups, dezocine combinded fentanyl group （D-F group） or fentanyl group （F group）. There were 30 patients in each group. Loading dose was given 10 minutes before completion of the operation. D-F group were given dezocine 0.1 mg/kg in intravenous injection, while F group were given fentainyl in a dose of 1μg/kg. Analgesia pump （2 mE/h） was connected after conscious awake. Prescription for analgesia pump was as follows. Dezocine 0.4 mg/kg ＋ Fentanyl 8 txg/kg ＋ droperidol 5 mg were added into 100 ml 0.9% sodium chloride injection in D-F group. F group added fentanyl 16μg/kg ＋ droperidol 5 mg into 100 ml 0. 9% sodium chloride injection. Effect and complication in two groups were observed and analyzed. Results There was no significant difference between two groups in analgesia effect （ P 〉 0 05 ）. But total adverse reaction incidence ratio in D-F group was obviously lower than that in F group （ P 〈 0.05 ）. Conclusion Dezocine and fentanyl combination intravenous injection for postoperative pain has many advantages such as satisfactory clinical effect, few adverse reaction incidences and reliable security.