瑞芬太尼分别复合地佐辛与芬太尼对胆囊摘除术患者的镇痛效果比较

Effect of remifentanil combined with dezocine or fentanyl on analgesia in cholecystectomy

目的探讨瑞芬太尼复合地佐辛与芬太尼对胆囊摘除术患者镇痛效果。方法选取武警浙江省总队嘉兴医院普外科行胆囊切除术患者98例,按随机数字表法进行分组,对照组49例给予瑞芬太尼复合芬太尼静脉注射;研究组49例给予瑞芬太尼复合地佐辛0.1 mg/kg静脉注射,观察并记录2组患者苏醒时(T1)、苏醒后1 h(T_2)、2 h(T_3)的疼痛与镇静评分,生命体征变化情况,同时记录2组患者的苏醒与拔管时间,对比不良反应状况。结果研究组在T_1、T_2、T_3时视觉模拟评分法(visual analogue scale,VAS)及T_2、T_3时Ramsay镇静评分法(Ramsay sedation scale,RSS)低于对照组,术后苏醒与拔管时间显著低于对照组,差异具有统计学意义(P<0.05);2组间T_0、T_1、T_2、T_3时生命体征差异无统计学意义,2组患者术后均无呼吸抑制等不良反应发生;对照组不良反应发生率(16.33%)与研究组(10.20%)比较,差异无统计学意义。结论地佐辛复合瑞芬太尼对术后痛觉过敏具有良好抑制作用,不良反应少。

Objective To investigate the effect of remifentanil combined with dezocine or fentanyl on analgesia in patients with cholecystectomy.Methods A total of 98 patients with cholecystectomy from our hospital were collected,patients were randomly divided into the experimental group and control group with 49 cases in each group. Patients in the control group were treated by remifentanyl combined with fentanyl intravenous injection and patients in the experimental group were treated by remifentanyl combined with dezocine intravenous injection. The analgesia and sedation score and vital signs changes at recovery time（ T1）,after recovery 1h（ T2）,2 h（ T3）,and the revival time,extubation time and adverse reactions were compared between two groups. Results The visual analogue scale score in experimental group at T1,T2,T3 and Ramsay sedation scale（ RSS） at T2,T3 were lower than control group,the revival time and extubation time in experimental group were lower than control group,with significant difference（ P〈0. 05）.There was no significant difference at T0,T1,T2 and T3 between two groups. There was no respiratory depression happened in two groups,and there was no significant difference in adverse drug reaction between control group and experimental group（ 16. 33% vs. 10. 20%）. Conclusion The remifentanil combined with dezocine has a good inhibitory effect on postoperative hyperpathia with less adverse reactions.