地佐辛用于胃癌术后自控镇痛的效果观察

Effect observation of patient-controlled analgesia with dezocine on postoperative gastric cancer patients

目的 观察地佐辛用于胃癌术后自控镇痛的效果及安全性.方法 将60例ASA Ⅰ～Ⅱ择期行胃癌手术患者随机分为地佐辛组和舒芬太尼组,每组30例,术后行静脉自控镇痛（PCIA）.地佐辛组给予地佐辛0.7mg/kg加盐酸托烷司琼0.2mg/kg,以0.9%氯化钠注射液稀释至100ml;舒芬太尼组给予舒芬太尼3μg/kg加盐酸托烷司琼0.2mg/kg以0.9%氯化钠注射液稀释至100ml.观察2组患者术后0～1、4、8、12、24、48h视觉模拟评分（VAS）、镇静程度评分（Ramesy）以及不良反应发生情况.结果 2组术后各时间点的VAS评分间比较差异无统计学意义（P〉0.05）,但舒芬太尼组术后0～1h、4h、8h Ramsay评分明显高于地佐辛组,差异有统计学意义（P〈0.05）.地佐辛组恶心、呕吐发生率明显低于舒芬太尼组,呼吸抑制和需要追加止吐药率也明显低于舒芬太尼组,差异均有统计学意义（P〈0.05）.结论 地佐辛用胃癌术后自控镇痛效果确切,不良反应少,可用于临床.

Objective To observe the efficacy and safety of patient-controlled analgesia with dezocine on postopera- tive gastric cancer patients. Methods 60 cases of patients with ASA I ~ 1] undergoing gastric cancer operation were random- ly divided into the dezocine group and sufentanil group, each of 30 cases. The patient-controlled intravenous analgesia （PCIA） was performed on all the patients after operation. The dezocine group was given dezocine （0.7mg/kg） plus tropisetron hydro- chloride （0.2mg/kg） ,which was diluted to 100ml by using 0.9% sodium chloride injection. The sufentanil group was received sufentanil （3 μ g,/kg） and tropisetron hydrochloride （0.2mg/kg） ,which was diluted to 100ml by using 0.9% sodium chloride injection. The visual analog scale observation （VAS） ,sedation score （Ramesy） and incidence of adverse reactions of 2 groups were observed in 0 - 1,4,8,12,24,48h after operation. Results There was no significant difference of VAS between 2 groups at each time point after operation （ P 〉 0.05 ）, but the Ramesy score of sufentanil group was higher than that of the dezocine group in 0 - lh,4h,8h after operation, and the difference was statistically significant （ P 〈 0.05 ）. The incidence of nausea, vomiting of dezocine group was lower than that of sufentanil group, and the respiration inhibition and the need for additional an- tiemetics rate of which was lower than that of sufentanil group, the differences were statistically significant （ P 〈 0.05 ）. Con- clusion It is effect for patient -controlled analgesia with dezoeine on postoperative gastric cancer patients, with less adverse reaction, which can be used in clinical.