地佐辛用于瑞芬太尼复合吸入麻醉后痛觉过敏的临床效果

Effect of dezocine on postoperative hyperalgesia after remifentanil combined with inhalation anesthesia

目的 观察地佐辛用于瑞芬太尼复合吸入麻醉后痛觉过敏的疗效。方法 腹腔镜下胆囊切除术患者80例，随机分为4组，所有患者术中均采用瑞芬太尼和七氟烷维持麻醉，手术结束前20min分别静脉注射地佐辛0.1mg·kg^-1（D1组）、0.15mg·kg^-1（D2组），芬太尼2ug·kg^-1（F组）与对照组（R组）。记录各组的苏醒时间、拔管时间、拔管后口述疼痛评分、术后VAS评分与不良反应。结果 R组和D组患者苏醒和拔管时间显著短于F组（P〈0.05）。苏醒后的口述疼痛评分与VAS评分R组最高，D1组次之，D2组、F组最低（P〈0.05）。R组要求镇痛药者较多。结论地佐辛对瑞芬太尼麻醉术后痛觉过敏具有较好的抑制作用，且无明显不良反应。

Objective To investigate the effect of dezocine on postoperative hyperalgesia in- duced by remifentanil combined with inhalation anesthesia. Methods Eighty patients scheduled for selective laparoscopic cholecystectomy were randomly divided into four groups. Anesthesia was main- tained with intravenous injection of remifentanil and sevoflurane inhalation. Dezocine O.1 mg· kg^-1 （group D1）, 0.15 mg· kg^-1 （group D2）, fentanyl 2 ug· kg^-1（group F） and normal saline 2 ml （group R） were given at 20 min before the end of the surgery. The times of recovery and extubation, oral pain score and VAS after the operation, and adverse reactions were recorded. Results Recovery and extubation times in group R and D were obviously shorter than those in group F （P〈O. 05）. The highest oral pain score and VAS were in group R, and the patients need more analgesics in this group. Conclusion Dezocine alleviate the hyperalgesia after remifentanil and inhalation anesthesia, and without obvious adverse reactions.