烧伤病人切削痂植皮术后三种不同药物镇痛效果的观察

Efficacy of three different pain medications after shaving or excising eschar in deeply burned patients

目的比较镇痛药物地佐辛、芬太尼、曲马多用于切削痂植皮术后静脉镇痛的效果及安全性。方法择期行切削痂植皮术全麻患者84例,随机分为3组。术毕各组分别静脉注射地佐辛0.1 mg.kg-1,芬太尼0.002 mg.kg-1,曲马多2 mg.kg-1。观察并记录各组VAS评分、Ramsay镇静评分,并进行安全性评价。结果地佐辛组和芬太尼组在0.5,1,4 h观察时段VAS评分明显低于曲马多组(P<0.05);地佐辛组在0.5,1 h观察时段Ramsay镇静评分显著高于芬太尼组和曲马多组(P<0.05);3组均有胃肠道不良反应,组间无统计学意义(均P>0.05)。结论静脉注射地佐辛0.1 mg.kg-1对烧伤病人切削痂植皮术后安全有效。

Objective To explore the effect of three different pain medications when using after shaving or excising eschar in deeply burned patients.Methods84 patients treated with excision of eschar and dermepenthsis of empyrosis were divided into three groups randomly,which were respectively injected with Dezocine 0.1 mg·kg-1,Fentanyl 0.002 mg·kg-1,and Tramadol 2 mg·kg-1 when the surgery was over.Compare the VAS analgesic score,Ramsay sedative score and the side reaction among the three groups.They were recorded within 24 h after operations.ResultsThe VAS scores of dezocine group and fentanyl group were much lower than those of tramadol group at 0.5,1,4 h after operation（P〈0.05）.The Ramsay sedative score of dezocine group were much higher than those of fentanyl group and tramadol group at 0.5,1 h after operation（P〈0.05）.The patients in three groups all had gastrointestinal side effects without statistics difference（P〉0.05）.ConclusionIntravenous dezocine 0.1 mg·kg-1 is effective and safe for deeply burned patients with shaving or excising eschar operation.