苏芬太尼联合地佐辛在直肠癌根治术后静脉镇痛中的应用

Postoperative Analgesic Effects of Sufentanil Combined with Dezocine in Patients with Rectal Cancer Undergo- ing Radical Resection

为观察苏芬太尼联合地佐辛在直肠癌根治术全麻术后静脉镇痛中的应用效果，随机选取直肠癌根治术全麻患者80例分为两组，A组为苏芬太尼组，B组为地佐辛＋苏芬太尼组，每组各40例。A组术毕前15min给予苏芬太尼0．2μg／kg负荷剂量，静脉自控镇痛（PCIA）配方为苏芬太尼2．5／zg／kg＋昂丹司琼4mg＋地塞米松10mg＋生理盐水稀释至100ml；B组术毕前15min给予地佐辛0．1mg／kg负荷剂量，PCIA配方为地佐辛O．4mg／kg＋苏芬太尼2．0μg／kg＋昂丹司琼4mg＋地塞米松10mg＋生理盐水稀释至100ml。镇痛泵速度为2ml／h，患者自控计量为0．5ml／次，锁定时间为15min。观察记录两组患者术后2、4、8、12、24、36、48h的疼痛评分（VAS），镇静评分（Ramsay），舒适度评分（BCS）以及不良反应的情况。结果显示，A、B两组均能提供相对良好的术后镇痛效果，其中在VAS、Ramsay、BCS各个时间点无统计学意义（P〉0．05），但在术后不良反应发生率方面B组明显低于A组（P〈O．05）。结果表明，苏芬太尼联合地佐辛在直肠癌根治术全麻术后PCIA，效果确切满意，不良反应发生率低。

This study was to observe the postoperative analgesic effects of sufentanil combined with dezocine in patients with rectal cancer undergoing radical resection,80 cases were randomly divided into group A （sufentanil group） and group B（dezocine＋ sufentanil group）, 40 cases for each group.Sufentanil was given to group A at the loading dose of 0.2μg/kg 15 min before the completion of surgery;patient controlled intravenous analgesia（PCIA） solution contained sufentanil （2.5 μg/kg）,ondansetron （4 mg） and dexamethasone （10 mg） diluted to in 100 ml with normal saline.Dezocine was given to group B at the loading dose of 0.1mg/kg 15 rain before the completion of surgery; PCIA solution contained dezocine （0.4mg/kg）, sufentanil（2.0μg/kg） ,ondansetron （4 rag） and dexamethasone （10 rag） diluted to in 100 ml with normal saline.The intravenous speed was controlled to 2 ml/h by analgesia pump,0.5 ml each time by patients, with the locking time of 15 min. Both groups were observed for scores of VAS,Ramsay and BCS,and ad- verse reactions at 2,4,8,12,24,36,48 h after surgery. The results showed that postoperative analgesic effects were successfully achieved in both groups,which showed no significant difference in VAS, Ramsay and BCS at different time points（ P〉0.05）.Group B had a lower incidence of adverse reactions than group A（ P 〈0.05）.It is concluded that sufentanil combined with dezocine in PCIA for patients rectal cancer undergoing radical resection is of potent efficacy and lower adverse reactions.