右美沙芬用于80例胆囊切除术后镇痛的临床观察与分析

Observation and Analysis on Analgesia after Cystic Resection of 80 Cases with the Dextromethorphan

目的：观察和分析右美沙芬用于80例胆囊切除术的超前镇痛作用临床疗效。方法：将2009年8月-2011年11月我院接收并确诊的80例ASAI～II级择期行腹腔镜胆囊切除手术患者，按患者意愿随机分为两组。治疗组40例，麻醉诱导前30min肌注右美沙芬20mg；对照组40例，麻醉诱导前30min肌注等量生理盐水。术中监测患者的血氧饱和度值、心率、平均动脉压等；术后统计术中（除麻醉诱导外）镇痛药的用量，并对患者伤口疼痛进行VAS评分。结果：对照组术中镇痛药（除麻醉诱导外）用量大于治疗组，但二者无统计学差异（P〉0．05），术后伤口无痛者治疗组明显多于对照组，治疗组VAS评分显著低于对照组，差异有统计学意义（P〈0．01）。结论：右美沙芬对于胆囊切除术有超前镇痛的作用，麻醉诱导前30min肌注20mg，不仅可以减少术中镇痛药的用量，而且在更大程度上减轻了术后患者伤口的疼痛。

Objective： To observe and analyze clinical curative effect of analgesia after cystic resection of 80 cases with the dextromethorphan. Methods： Divide 80 cases ofASA I - II from August 2009 to November 2011 received and diagnosed in laparoscopic gallbladder surgery patients into two groups, randomly according to the patients＇ will. The treatment group in 40 cases, intramuscular inject dextromethorphan 20 mg before narcotic induction 30 min; The control group in 40 cases, intramuscular inject amount saline before narcotic induction 30 min. To monitor patients＇ aorta pressure, heart rate, oxygen saturation values, etc during the operation. Statistics intraoperative （except the narcotic induction） analgesic drug dosage after the operation, and the wound on patients with pain VAS score. Results： The control group intraoperative analgesics （except the narcotic induction） dosage is greater than the treatment group, but not statistical difference （P〉0.05）. The treatment group postoperative wound the painless significantly more than the control group, and the treatment group VAS score significantly lower than those of the control group, and the difference was statistically significant （P〈0.01）. Conclusion： The dextromethorphan for cystic resection has the role of preemptive analgesia. Intramuscular injecting 20 mg before 30 min narcotic induction can not only reduce the dosage of intraoperatie analgesics, but also reduce the postoperative patients wound of pain in greater extent.