地佐辛联合吗啡用于脊柱骨折全麻术后患者自控镇痛的研究

Effect of dezocine combined with morphine after general anesthesia for spinal fractures on patient-controlled analgesia

目的探讨地佐辛联合吗啡用于脊柱骨折全麻术后自控镇痛（patient controlled intravenous analgesia,PCIA）的镇痛效果及不良反应。方法 2011年1月至2014年1月我院全麻下行脊柱骨折内固定手术患者90例,采用随机数字法分为观察组及对照组各45例。两组术后均进行PCIA,对照组予以吗啡,观察组予以地佐辛联合吗啡。比较两组患者术后3、6、12、24、48 h的视觉模拟评分（VAS）、舒适度评分（BCS）、Ramsay评分以及不良反应。结果术后3～24 h各时间点观察组患者的Ramsay评分均明显高于对照组,差异有统计学意义（P〈0.05）;两组术后各时点VAS评分及BCS评分比较差异无统计学意义（P〉0.05）;观察组并发症发生率为4.44%,明显低于对照组的22.22%,差异有统计学意义（χ2=6.154,P〈0.05）。结论吗啡联合地佐辛应用于脊柱骨折术后的静脉镇痛效果良好,且不良反应少,值得推广应用。

Objective To investigate the effect of dezocine combined with morphine after general anesthesia for spinal fracture on patient-controlled analgesia（PCA） and their adverse reactions.Methods Ninety patients underwent spinal fracture internal fixation operation from Jan.2011 to Jan.2014 in our hospital.They were randomly divided into observation and control groups,45 cases in each group.The control group was given morphine while the observation group was treated with dezocine combined with morphine.The visual analog scale（VAS）,Bruggman comfort scale（BCS）,Ramesay score and adverse reaction conditions were compared after 3,6,12,24 and 48 h between the two groups.Results After 3-24 hours of operation,the Ramsay score at different time pints in the observation group was significant higher than that in the control group（P〈0.05）.There was no significant difference in the VAS score and BCS scores at different time points between the two groups.In the observation group,the incidence of complications was 4.44% that was significantly lower than that in the control group（22.22%）（χ2= 6.154,P〈0.05）.Conclusion Morphine combined with dezocine used in spinal fracture postoperative analgesia and sedative has a good effect,and can reduce the adverse reactions.It is worthy of popularization.