地佐辛复合舒芬太尼用于腹部肿瘤手术后镇痛的效果

The Analgesic Effect of Dezocine Combined with Sulfentanyl in Patients Undergoing Abdominal Cancer Surgery

目的观察地佐辛复合舒芬太尼用于腹部肿瘤手术后镇痛的效果。方法将择期行腹部肿瘤手术患者75例随机均分为A、B、C 3组,手术结束前30 min静脉给予舒芬太尼10μg,术后48 h行患者静脉自控镇痛(PCIA),A组PCIA配方为地佐辛0.2 mg·kg-1加舒芬太尼1μg·kg-1,B组PCIA配方为地佐辛0.2mg·kg-1加舒芬太尼2μg·kg-1,C组PCIA配方为舒芬太尼2μg·kg-1,3组PCIA药物均用生理盐水稀释成100 mL,持续剂量2 mL.h-1,PCA量每次0.5 mL。记录术后1(T1)、4(T2)、8(T3)、12(T4)、24(T5)h疼痛视觉模拟评分(VAS)、镇静评分及恶心、呕吐、嗜睡、皮肤瘙痒、呼吸抑制等毒副反应,记录术后24 h PCIA按压次数。结果 3组患者术后各时点SBP、DBP、HR、SpO2、安静时和活动时的VAS评分、镇静评分、术后24 h PCIA按压次数比较差异均无统计学意义(P均>0.05)。A组术后24 h出现恶心、呕吐的患者少于B、C组。结论地佐辛0.2 mg·kg-1加舒芬太尼1μg·kg-1用于腹部肿瘤手术后的镇痛效果好,毒副反应轻。

Objective To investigate the analgesic effect of dezocine combined with sulfentanyl in the patients undergoing abdominal cancer surgery. Methods Seventy-five patients scheduled for abdominal cancer surgery were randomly divided into three groups of each 25 cases. All the patients were injected intravenously sulfentanyl 10 μg at 30 min before the end of surgery. PCIA was given dezocine 0.2 mg ·kg^-1 and sulfentanyl 1μg·kg^-1 in group A, and dezocine 0.2 mg ·kg^-1 and sulfentanyl 2μg·kg^-1 in group B. The patients in group C were given sulfent- anyl 2 μg·kg^-1 in PCIA. The drugs were diluted into 100 mL, the continuous dose was 2 mL · h-1, and the sin- gle dose was 0.5 mL per time. The analgesic effect was measured by the VAS and sedation scores at 1 （T1 ）, 4 （ T2 ）, 8 （T3 ）, 12 （T,）, 24 （T5 ） h after surgery and the pressing times in 24 h after surgery, and the toxicities were recorded too. Results There were no differences among the three groups in the SBP, DBP, HR, SpO2, VAS scores, sedation scores and the pressing times. The incidences of nausea, vomiting in group A were less than those in group B and group C. Conclusion Intravenous analgesia of dezocine 0.2 mg · kg^ - 1 combined with sulfentanyl 1μg·kg^-1 offers favorable analgesic effect in patients undergoing abdominal cancer surgery, and the toxicities are light.