地佐辛与芬太尼在产科术后镇痛临床疗效比较

Comparison of the analgesic effects of dezocine and fentany1 after gynecologic surgery

目的比较地佐辛与芬太尼对剖宫产手术后产妇自控静脉镇痛（PCIA）的镇痛效果与不良反应。方法选择ASAⅠ~Ⅱ级剖宫产足月产妇140例,随机分为地佐辛组和芬太尼组,每组70例,术后实施PCIA。地佐辛组予以地佐辛0.8mg/kg＋氟哌利多5 mg,芬太尼组予以芬太尼15μg/kg＋氟哌利多5 mg,均加0.9%氯化钠溶液至100 mL。观察并记录术后4、8、12、24、48 h各时点VAS评分、不良反应。结果 2组产妇的VAS评分差异无统计学意义（P〉0.05）,但术后地佐辛组产妇恶心呕吐、头晕嗜睡、尿潴留等不良反应发生率明显低于芬太尼组（P〈0.05）。结论地佐辛与芬太尼用于剖宫产手术后PCIA,镇痛效果均较好,但地佐辛的不良反应发生率较低。

Objective To compare the analgesic effects and adverse reactions of dezocine and fentanyl on puerperas with patient-controlled intravenous analgesia（PCIA） after cesarean section.Methods A total of 140 patients who were performed with ASA levels I and II cesarean section were equally randomized into dezocine group and the fentanyl group.PCIA was implemented after operation.The dezocine group received dezocine（0.8 mg/kg） and droperidol（5 mg）.Fentanyl group received fentanyl（15 μg/kg） and droperidol（5 mg）.NaCl solution（0.9%） was added to reach 100 mL in both groups.The VAS scores at 4 h,8 h,12 h,24 h,48 h and adverse reactions were observed and recorded.Results The VAS scores in the two groups had no statistical difference（P0.05）,but the incidence of nausea and vomiting,dizziness,drowsiness,postoperative urinary retention in dezocine group were significantly lower than in the fentanyl group（P0.05）.Conclusion Dezocine and fentanyl have a fairly good analgesic effect in cesarean section after PCIA,but dezocine has a lower rate of adverse reactions.