地佐辛-舒芬太尼与曲马多-舒芬太尼用于腹部手术术后镇痛的安全性和有效性比较

Comparing the Efficacy and Safety of Postoperative Analgesia Using Dezocine or Tramador Combined with Suifentanil

目的比较地佐辛-舒芬太尼与曲马多-舒芬太尼用于腹部手术术后镇痛的安全性及有效性。方法 120例腹部手术接受全身麻醉患者,按患者意愿分为两组,每组60例。D组为地佐辛配伍舒芬太尼,T组为曲马多配伍舒芬太尼。比较术后4、8、16、24、48 h疼痛视觉模拟评分(visual analogue pain scale,VAS)、舒适度评分(Bruggman comfort score,BCS)及Ramsay镇静评分与不良反应。结果两组术后镇痛效果相似,VAS评分相比差异无统计学意义(P>0.05),两组舒适度评分(BCS)差异无统计学意义(P>0.05),两组术后Ramsay镇静评分差异无统计学意义(P>0.05)。头昏发生率D组低于T组,差异无统计学意义(P>0.05),恶心呕吐及皮肤瘙痒发生率D组低于T组,差异有统计学意义(P<0.05)。D组花费较T组高。结论地佐辛-舒芬太尼与曲马多-舒芬太尼术后镇痛确切,效果相似;并发症发生率T组高于D组,D组效果整体优于T组,但D组价格昂贵,可根据患者不同情况选择。

Objective To compare the efficacy and safety between dezocine combined with sufentanyl and tramadol with sufentanyl after Epigastrium operation. Methods 120 patients received general anesthesia during selective epigastrium operation, who would undergo postoperative analgesia,were divided into two groups with 60 cases for each. The dezocine combined with sufen-tanyl（group B）or tramadol combined with sufentanyl（group T）were used respectively. The visual analogue scale（VAS）,Brug-mann comfort score（BCS）,Ramsay sedative score and side effects were recorded and compared between two groups on 4,8,16, 24,48 h after the operation. Results There was no significant difference in VAS and BCS（P〉0. 05）. There was no significant difference in Ramsay score of group between two groups. The incidence of dizzy in group T was higher than group D（P〈0. 05）. The incidence of postoperative nausea,vomiting（ PONV） and pruritus of group D was significantly lower than those of group T（ P〈0. 05）. The cost of D was higher than the group T. Conclusion The use of dezocine or tramador combined with sufentanyl has a good effect of analgesia in patients-controlled analgesia after epigastrium operation. The incidence of the complications in the group T was higher than the group D.