地佐辛联合氯胺酮术后自控静脉镇痛疗效观察

Analgesia effects of PCIA with dezocine combined with ketamine in abdominal operation

目的观察地佐辛联合小剂量氯胺酮用于腹部手术后自控静脉镇痛的效果与安全性。方法 40例ASAⅠ～Ⅱ级择期拟行肠癌或胃癌根治术患者,随机分为2组,地佐辛复合氯胺酮组(DK组,地佐辛0.3mg/kg+氯胺酮2mg/kg+盐酸昂丹司琼8mg+生理盐水稀释至100ml)与地佐辛组(D组,地佐辛0.6mg/kg+盐酸昂丹司琼8mg+生理盐水稀释至100ml),每组20例。术中采用静吸复合全麻,术毕接PCIA镇痛。观察2组患者术后3、6、12、24、48h视觉模拟评分(VAS)、镇静程度评分(Ram-say)及不良反应的情况。结果 DK组患者的VAS评分与D组相比无显著差异,Ramsay镇静评分及不良反应显著优于D组(P<0.05)。结论腹部手术后地佐辛联合小剂量氯胺酮PCIA镇痛效果确切、不良反应少。

Objective To evaluate the analgesia effects of PCIA with dezocine combined with ketamine in abdominal operation.Methods A total of 40 patients with ASAⅠ～Ⅱ underwent abdominal operation under general anesthesia were randomly divided into 2 group（n=20,each） which were treated with PCIA after the operation.The two group were dezocine group（Group D,n=20）,and dezocine combined with ketamine group（Group DK,n=20）.PCIA gradients used for group D and group DK were dezocine 0.6 mg/kg＋Ondansetron HCL 8 mg and dezocine 0.3 mg/kg＋ketamine 2 mg/kg＋Ondansetron HCL8 mg,separately,which were diluted to be 100 ml by adding saline.VAS,Ramsay scores and side effects were recorded and compared.Results There was no significant difference in VAS score between two groups,but DK group showed better outcomes regarding to the Ramsay score,and less side effects comparing with group D（P0.05）.Conclusion Dezocine combined with ketamine in PCIA exhibits exact analgesia effect with less side effects.