地佐辛在小儿腹腔镜下疝修补中抑制瑞芬太尼痛觉超敏的作用

The effects of Dezocine on inhibiting Remifentanil-induced pain hypersensitivity during pediatric laparoscopic hernia repair

目的探讨地佐辛在小儿腹腔镜下疝修补术中对瑞芬太尼的麻醉后痛觉过敏作用,总结其临床应用价值。方法选取腹腔镜下做小儿疝修补术的患儿90例,随机分为观察组和对照组。两组均采用瑞芬太尼全身麻醉。在手术结束前30min,对照组静脉给予生理盐水,观察组给予地佐辛。记录并对比两组的用药起效时间、手术时间、术后自主呼吸恢复时间、术后气管插管拔管时间、术后苏醒时间等情况,苏醒后进行疼痛评分。结果对两组患儿用药的起效时间、手术持续时间、术后自主呼吸恢复时间、术后气管插管拔管时间、术后苏醒时间进行比较,组间差异无统计学意义(P>0.05)。观察组术后疼痛0级34例,1级6例,2级4例,3级1例;对照组术后疼痛0级26例,1级7例,2级7例,3级4例,4级1例,观察组疼痛程度低于对照组,差异有统计学意义(P=0.047)。结论在小儿腹腔镜下疝修补术中地佐辛对瑞芬太尼麻醉后痛觉过敏的预防具有明显的效果,可明显缓解患者的疼痛度,值得临床推广。

Objective To explore the effects of Dezocine on inhibiting pain hypersensitivity caused by remifentanil during pediatric laparoscopic hernia repair. Methods Ninety cases who received pediatric laparo-scopic hernia repair were randomly divided into an observation group and a control group.Both groups used Remifentanil general anesthesia.The control group was given normal saline,and observation group was given Dezocine 30 minutes before the end of the operation.Compared the drug onset time,operation duration,post-operative spontaneous breathing recovery time,post-operative airway extubation time,post-operative awa-king time between the two groups,and pain scale was done after awaking. Results There was no statistically significant difference in comparison of onset time of drug effect,operation duration,postoperative spontaneous breathing recovery time,postoperative extubation time,postoperative awaking time from anesthesia between the two groups （P〉0.05）.Thirty-four cases of the observation group had postoperative grade 0 pain score, 6 cases had grade 1,four cases had grade 2,1 case had grade 3;26 cases of the control group had postoperative grade 0 pain score,7 cases had grade 1,7 cases had grade 2,4 case had grade 3,1 case had grade 4.Postopera-tive pain degree of observation group was obviously lower than the control group,and the difference was statis-tically significant （P =0.047）. Conclusion Dezocine is effective on preventing pain hypersensitivity caused by remifentanil during pediatric laparoscopic hernia repair,which can obviously ameliorate the patients＇pain and be worthy of clinical recommendation.