地佐辛对单侧膝关节镜手术患者术后疼痛的影响

THE EFFECTS OF DEZOCINE ON THE POSTOPERATIVE PAIN OF PATIENTS WITH UNILATERAL ARTHROSCOPIC KNEE SURGERY

目的：探讨术中静脉注射地佐辛对单侧膝关节镜手术患者术后疼痛的影响。方法：采用随机数字表法将60例ASAⅠ~Ⅱ级择期行单侧膝关节镜手术的患者分为3组：实验组1组（D1组）、实验组2组（D2组）和对照组（C组）,每组20例。所有患者均采用气管内插管全身麻醉,且术后均未应用自控镇痛装置。在常规麻醉的基础上,D1组患者切皮前5min静脉注射地佐辛0.1mg/kg,D2组患者切皮前5min及手术结束即刻分别静脉注射地佐辛0.1mg/kg,C组患者不做特殊处理。用疼痛视觉模拟评分法（VAS评分）评估患者术后4h、8h、12h、24h、48h的疼痛程度,观察术后48h内其他镇痛药的使用情况以及恶心呕吐、呼吸抑制等不良反应的发生率。结果：D2组患者术后4h、8h、12h、24h的VAS评分及D1组患者术后4h、8h的VAS评分均比C组低,差异均有统计学意义（均P〈0.05）。D2组患者术后8h、12h、24h的VAS评分均比D1组低,差异有统计学意义（P〈0.05）。3组患者术后48h内镇痛药物的使用率以及恶心呕吐、头晕、呼吸抑制等不良情况的发生率比较,差异无统计学意义（P〉0.05）。结论：术中静脉注射地佐辛可减轻膝关节镜手术患者的术后疼痛,且不增加不良反应的发生率。

Objective. To investigate the effects of dezocine on the postoperative pain of patients with unilateral arthroscopic knee surgery. Methods. Sixty patients （ASAⅠ-Ⅱ） undergoing unilateral arthroscopic knee surgery were randomly divided into three groups （ n = 20）. experimental groups （Group D1 and Group D2） and control group （Group C）. The patients in Group D1 were injected with dezocine 0.1 mg/kg intravenously 5 rain before incision. The patients in Group D2 were injected with dezocine 0.1 mg/kg intra-venously 5 min before incision and at the end of operations. There is no special treatment with the patients in Group C. The degree of postoperative pain was assessed by the visual analogue scale （VAS） at 4 h, 8 h, 12 h, 24 h and 48 h after operations. The dosage of analgesic and adverse reactions such as nausea, vomi- ting and respiratory inhibition were recorded in 48 h after operations. Results： There was no significant difference in age, height, weight and the duration of anesthesia among the three groups （ P〉0.05）. The VAS scores of patients in Group D2 were lower than that in Group C at 4 h, 8 h, 12 h and 24 h after operations （ P〈0.05）. The VAS scores of patients in Group D1 were lower than that in Group C at 4 h and 8 h after operations （ P〈0.05）. At 8 h, 12 h and 24 h after operations, the VAS scores of patients in Group D2 were lower than that in Group D1 （ P 〈0.05）. There were no difference in dosage of analgesic and the incidence of adverse reactions in 48 h after operations among three groups （ P〉0.05）. Conclusion. Intrave-nously injection of dezocine could relieve early postoperative pain and didn＇t increase the incidence of ad- verse reactions after operation in patients undergoing unilateral arthroscopic knee surgery.