预注射地佐辛对减轻人工膝关节置换术后疼痛及不良反应的效果观察

Study on analgesic effect and side- effects of preemptive dezocine in patients with total knee arthroplasty

目的:探讨预先注射地佐辛对膝关节置换手术TKA后止痛效果和不良反应的影响。方法:观察择期行TKA术的患者79例,随机分为试验组(E组,40例)和对照组(C组,39例),E组预注射地佐辛5 mg,C组予NaCl溶液,手术结束后两组均行自控静脉镇痛泵(PCIA)。记录比较两组术后不同时段VAS评分、PCIA按压次数、芬太尼用量和不良反应的发生率。结果:E组镇痛效果要明显优于C组,两组在不同的各个时间点VAS评分差异有统计学意义,在6 h、24 h两个时间点按压次数差异有统计学意义,两组4 h、12 h、24 h芬太尼总用量差异有统学意义,C组术后不良反应发生率高于E组,差异有统计学意义(P<0.05)。结论:预先注射地佐辛对膝关节置换手术安全有效,有加强术后镇痛的效果,减少止痛药物用量。

Objective To study the analgesic effect and side - effects of preemptive dezocine applied in patients with total knee arthro- plasty （TKA）. Methods 79 patients with TKA were randomly divided into test group（ group E, n = 40） and control group（ group C, n = 39）. In group E,5mg dezocine was intravenously injected before TKA, and the same dose salt water was used in group C. Patient controlled intravenous analgesia （PCIA） was used in all patients after operation. Scores of visual analog scales （VAS） in different time points, times for PCIA,doses of Fentanyl and the side - effects were recorded. Results Patents in group E had a better analgesic effect than those in group C, scores of VAS in different time points were significantly different between two groups. Times for PCIA in time point of 6 and 24 were sig- nifieandy different between two groups. Doses of Fentanyl in 4h, 12h ,24h were significantly different between two groups. There were signifi- cant more side -effects in group C than in group E（ P 〈0. 05 ）. Conclusion Preemptive Dezocine is safe for patients with TKA ,can effec- tively increase postoperative analgesic effect and decrease the dose of analgesic drugs.