地佐辛配伍罗哌卡因用于妇科患者术后镇痛的临床研究

Dezocine combined with ropivacaine for postoperative analgesia in patients after gynecological operation

目的观察地佐辛配伍罗哌卡因用于妇科患者手术后镇痛的安全性和有效性。方法择期行子宫与附件切除术患者50例，随机分为试验组和对照组，每组25例，均采用连续硬膜外麻醉。试验组术后即刻持续硬膜外泵注低浓度地佐辛与罗哌卡因合剂，对照组同法泵注吗啡与罗哌卡因合剂，观察术后72h内的呼吸循环变化、镇痛评分、镇静评分与不良反应。结果试验组与对照组术后平均镇痛时间分别为（22±10）h与（21±9）h，差异无统计学意义（P〉0．05）；两组术后72h内VAs差异无统计学意义（P〉0．05）；试验组较对照组血流动力学平稳且术后不良反应少（P〈0．01）。结论地佐辛或吗啡配伍罗哌卡因用于妇科患者手术后镇痛效果均确切，但地佐辛无明显不良反应，可用于临床术后镇痛。

Objective To observe the reliability and effectiveness of postoperative analgesia using dezocine combined with ropivacaine after gynecological operation. Methods Fifty patients with hysterectomy and adnexeetomy were randomly divided into 2 groups. Continuous epidural anesthesia was used in all of the patients. In experimental group the patients were continuously infused with low concentration dezoeine and ropivaeaine by epidural pump after the operation instantly, and in control group with morphine and ropivacaine by the same way. The changes of hemodynamies, SpO2, respiratory rate, visual analogue scale, sedative score and side effects were recorded after the operation. Results In experimental and control groups, the duration of analgesia was （22±10）h and （21 ± 9）h respectively, there was no statistical difference （P〉0.05）. No significant difference was in VAS between the two groups. The side effects in the experimental group were significantly fewer than those in the control group. Compared with the control group, the hemodynamics in the experimental group were steady. Conclusions Dezocine or morphine combined with ropivaeaine by epidural infusion pump is both effective for postoperative analgesia, but dezoeine has lower side effects.