地佐辛、喷他佐辛用于腹腔镜子宫切除术后自控静脉镇痛的临床观察

Efficacy comparision of dezocine and pentazocine used in patient-controlled intravenous analgesia after laparoscopic hysterectomy

目的：探讨地佐辛、喷他佐辛用于腹腔镜子宫切除术后自控静脉镇痛的临床疗效。方法：将80例腹腔镜子宫切除术患者（ASAI或Ⅱ级）随机分为地佐辛组（D组）和喷他佐辛组（P组）各40例。D组选用地佐辛40mg加入0．9％氯化钠注射液100ml；P组选用喷他佐辛180mg加入0．9％氯化钠注射液100ml。均采用自控镇痛泵（100m1）以负荷剂量2ml＋持续剂量2ml／h＋自控镇痛每次0．5ml、锁定时间15min模式静脉镇痛。观察术后4、8、16、24和48h患者视觉模拟评分、Ramsay镇静评分，记录术后48h内患者有效自控镇痛按压次数。结果：D组术后4、8、16、24和48h患者视觉模拟评分和有效自控镇痛按压次数与P组差异均无统计学意义（P〉0．05）；D组术后Ramsay镇静评分、恶心、呕吐和嗜睡等发生率均低于P组（P〈0．05-P〈0．01）。结论：地佐辛、喷他佐辛用于腹腔镜子宫切除术后自控静脉镇痛均可获得满意的效果，地佐辛较喷他佐辛的不良反应少。

Objective：To observe the clinical efficacy of postoperative patient-controlled intravenous analgesia（PCIA） with dezocine and pentazocine on patients receiving laparoscopic hysterectomy. Methods：Eighty patients （ASA class I or II ） scheduled for elective laparoscopic hysterectomy were randomly divided into dezocine group（ group D, n = 40） and pentazocine group（ group P, n = 40）. Group D were administered 0.4 mg/ml dezocine and group P 1.8 mg/ml pentazocine both via 0.9% sodium chloride injection 100 ml by PCIA. The procedure of PCA was as follows：loading dose set 2 ml, continuous infusion set 2 ml/h and bolus set 0.5 ml with 15-minute lockout interval. The visual analogue score, ramsay sedation score, effective press times of the PCIA and adverse effects were determined and compared at 4,8,16,24 and 48 hour after operation. Results：There were no significant differences in visual analogue score and effective press times of PCIA between the two groups （ P 〉 0.05 ）. The ramsay sedation score and incidence of adverse events such as nausea, vomiting and somnolence were significantly lower in group D than in group P（ P 〈 0.05 to P 〈 0.01 ）. Conclusions ： Dezocine can be safely administrated to patients undergoing laparoscopic hysterectomy via PCIA with equal analgesic efficacy as pentazocine but less adverse effects.