地佐辛超前镇痛用于痔上黏膜环切吻合术40例

Efficacy of Dezocine Pre-Emptive Analgesia in Patients Undergoing Procedure for Prolapse and Hemorrhoids

目的观察地佐辛超前镇痛在痔上黏膜环切吻合术（PPH）中的效果。方法选择美国麻醉医师协会（ASA）Ⅰ~Ⅱ级择期行PPH手术患者80例,随机分为观察组和对照组,各40例。观察组于术前静脉注射地佐辛5 mg,对照组静脉注射等容量的O.9%氯化钠注射液。以警觉一镇静（OAA/S）法评定两组患者给药后镇静程度,以视觉模拟评分（VAS）评定患者术后2,4,8,12,24 h的疼痛程度,并记录追加镇痛药、不良反应等情况。结果观察组患者静脉注射地佐辛后收缩压、舒张压、呼吸频率、指脉搏血氧饱和度（spO_2）与对照组相比,均无统计学差异（P〉0.05）;观察组患者镇静评分为5分、4分的例数分别为35,5例,对照组分别为38,2例,差异无统计学意义（P〉0.05）;术后4,8,12 h,观察组vAS评分分别为（2.5±0.6）分、（2.8±0.5）分、（3.5±0.9）分,均明显低于对照组（P〈0.05）;观察组术后有3例（7.50%）、对照组有12例（30.00%）患者要求使用镇痛药,观察组例数明显少于对照组（P〈0.05）;两组患者术后均无明显不良反应发生。结论地佐辛超前镇痛可明显减轻PPH患者术后疼痛,且无明显不良反应。

Objective To observe the efficacy of dezocine pre-emptive analgesia in the patients undergoing procedure for prolapse and hemorrhoids（PPH）. Methods 80 ASA I - II patients undergoing PPH were randomly divided into the observation group and the control group. The observation group was intravenously dripped with dezocine 5 mg, while the control group with normovolemic 0.9% sodium chloride injection. The degree of sedation after medication in the two groups was assessed by the Observer Assessment of Sedation （OAA/S） method and the pain intensity was assessed at postoperative 2,4,8, 12,24h by using the visual analogue scale （VAS）.The additional analgesic drugs and adverse reactions were recorded, postoperatively, and the side effects were also recorded. Results Com- pared with the control group, the systolic blood pressure, diastolic blood pressure, respiratory rate and SpO2 in the observation group had no statistical differences（P〉0. 05）; the sedation scores were 5 points in 35 cases and 4 points in 5 cases in the observation group, which were 38 cases and 2 cases in the control group, The differences has no statistical significances（P〉 0.05）; the VAS scores at postoperative 4,8, 12 h in the observation group were （2. 5±0. 6）, （2.8 ±0.5） and （3.5 ±0.9）points respectively, which were signifi- cantly lower than those in the control group（P〈0. 05）; 3 cases （7.50%） in the observation group and 12 cases （30.00%） in the control group demanded to use analgesic drug after operation, the case number in the observation group was significantly less than that in the control group（ P 〈 0. 05）. No obvious adverse reactions were found in the two groups. Conclusion Dezocine pre-emptive analge- sia can significantly alleviate the postoperative pain in the patients with PPH without obvious adverse reactions.