地佐辛用于心房颤动射频消融术中疗效的观察

Efficacy of Dezocine for Atrial Fibrillation Radiofrequency Catheter Ablation

目的观察地佐辛用于心房颤动射频消融术中的疗效。方法 2013年4月-7月随机选取心血管内科拟行心房颤动射频消融术患者45例,根据随机双盲原则分为地佐辛组（D组）、吗啡组（M组）。常规术前探视,记录患者生命体征以及术前疼痛评分、舒适度评分。两组患者于手术开始前30 min静脉分别给予地佐辛5 mg或吗啡5 mg镇痛,术中监测血压、心率、血氧饱和度、心电图和疼痛评分、舒适度评分,根据患者疼痛情况分次静脉给予对应组别用药2~3 mg,术毕记录手术时间,术后2、6、24 h随访患者,评估患者疼痛状况以及不良反应。结果两组患者在手术时间、术中疼痛评级指数、术中疼痛视觉模拟评分差异有统计学意义（P〈0.05）,术中及术后不良反应发生率差异无统计学意义（P〉0.05）。结论地佐辛用于心房颤动射频消融术中镇痛效果优于吗啡,但仍然存在术后恶心、呕吐等不良反应,鉴于目前全身麻醉尚未能完全推行的情况下,地佐辛用于心房颤动消融术中镇痛可作为一种较理想的替代方案。

Objective To observe the efficacy of dezocine used for atrial fibrillation radiofrequency catheter ablation. Methods Forty-five patients who would undergo radiofrequency catheter ablation of atrial fibrillation were randomly chosen to be our study subjects between April and July 2013. According to the randomized and double-blind principle, they were divided into group D （dezocine group） and group M （morphine group）. During routine visits prior to surgery, we recorded the patients＇ vital signs, pain score and degree of comfort. Before the ablation procedure, 5 mg dezocine or 5 mg morphine was administered intravenously for patients in both the two groups. During the procedure, blood pressure, heart rate, oxygen saturation, electrocardiogram, pain scores, and comfort score of the patients were monitored. Furthermore, 2-3 mg dezocine or morphine were administered intravenously if additional analgesia was needed. The time of the procedure was recorded. The patients were followed up and evaluated 2, 6 h and 24 hours after the procedure. Results The procedure time, pain rating index, and visual analogue scores were significantly different between the two groups （P 〈 0.05）. Adverse reaction during or after the procedure was not significantly different （P 〉 0.05）. Conclusions The analgesic effect of dezocine is better than morphine for atrial fibrillation radiofrequency catheter ablation. The incidence of adverse reactions such as nausea and vomiting is still high. Dezocine for analgesia in atrial fibrillation ablation can be used as an ideal alternative instead of general anesthesia.