应用响应曲面法改进地佐辛和氟比洛芬酯术后镇痛效果的临床观察

Response surface analysis for improving flurbiprofen in combination with Dezocine in surgery patients postoperative analgesia

目的应用响应曲面法分析术后镇痛药地佐辛和凯纷互作用模型,获得最佳的有效镇痛浓度,达到良好的镇痛效果和更少的副作用发生。方法选择ASAI-II级拟行术后镇痛的手术患者90例,年龄18到60岁,随机分为低浓度组、高浓度组和响应曲面组。低浓度组静脉PCA药物浓度为地佐辛25mg+凯纷150mg+生理盐水到250ml,高浓度组PCA药物浓度为地佐辛50mg+凯纷250mg+生理盐水到250ml,响应曲面组应用响应曲面分析法得出地佐辛与凯纷相互作用模型,获得理想的药物配置浓度,与高低浓度组进行镇痛效果效果与副作用发生率的比较。结果通过响应曲面分析获得的地佐辛和凯纷镇痛浓度方案,镇痛效果与高浓度配比方案没有统计学差异优于低浓度组方案,恶心呕吐、头晕的发生率低于高浓度组有统计学意义。结论应用响应曲面法可以获得两种药物术后镇痛最佳配比,获得良好的镇痛,降低副作用的发生。

Objective Response surface analysis was applied to describe the pharmacodynamic interactions between dezocine and flurbiprofen in postoperative analgesia to get a better analgesic effect,and have less side-effects.Methods90 surgical patients,ASA I-II,aged 18 to 60,who undertook operation and postoperative analgesia,were randomly divided into experimental group,low-dose group and high-dose group.The low-dose group was given intravenous postoperative analgesia pump：dezocine 25mg＋flurbiprofen 150 mg dissolved to 250 ml 0.9%saline,the high-dose group was given intravenous postoperative analgesia pump：dezocine 50mg＋flurbiprofen 250 mg dissolved to 250 ml 0.9% saline and the experimental group was given a ideal scheme which obtained through the response surface model of dezocine and flurbiprofen,then the analgesic effect and the incidence of side-effects were compared.Results Compared with conventional schemes,the experimental group has no statistical differences in analgesic effect,but has lower incidence of nausea,vomiting and dizziness than the high-dose group.Conclusion The application of response surface analysis can analyze the interactions of drugs and reach an ideal scheme,which may obtain better analgesic effect and less adverse events.