地佐辛联合舒芬太尼用于脊柱矫形术后镇痛的研究

Efficiency of dezocine combined with sufentanil on postoperative analgesia for spinal deformity surgery

目的探讨地佐辛联合舒芬太尼用于脊柱矫形术后镇痛的疗效。方法选择我院2013年1月至2015年9月择期行脊柱矫形手术患者90例,按随机单盲法将患者分成地佐辛组、舒芬太尼组和联合组,每组30例。采用丙泊酚加七氟烷静吸复合的麻醉方式,3组患者术毕予以静脉镇痛泵分别采用不同的药物持续镇痛。观察3组术后2 h、6 h、24 h、48 h的视觉模拟评分法(VAS)疼痛评分、镇静评分(SS)、术后不良反应、术后镇痛参数(总自控次数、有效自控次数)及术后24 h和48 h的呼吸频率、动脉血气指标。结果联合组患者的VAS评分低于地佐辛组(P<0.05)。在SS评分和不良反应发生方面,联合组较地佐辛组、舒芬太尼组有明显优势。术后24 h、48 h的动脉血气指标比较,联合组的Sa O2、Pa O2均高于舒芬太尼组(P<0.05),联合组的Pa CO2低于地佐辛组、舒芬太尼组(P<0.05)。结论地佐辛联合舒芬太尼用于脊柱矫形手术的术后镇痛,镇痛效果确切,不良反应少,是一种较为理想的镇痛方式。

Objective To evaluate the efficiency of dezocine combined with sufentanil on postoertive analgesia for spinal deformity surgery. Methods Divided the 90 patients who were admitted into our hospital from January 2013 to September 2015 into three groups by ran- dom single blind method, namely the dezocine group, the sufentanil group and the combined group, with 30 cases in each group. All the patients underwnet propofol and sevoflurane static absorption compound anesthesia, and they were given continuous intravenous analgesia with different drugs after the surgery. Their visual analogue scale （VAS） score, sedation scale （SS） score, adverse reaction, total PCIA times, ef- fective PCIA times, respiratory rate and arterial blood gas were measured at 2,6,24,48 hours after operation. Results The VAS score of the combined group was lower than that of the dezocine group （ P 〈 0.05 ）. The combined group was significantly superior to the dezocine group and the sufentanil group in SS score and adverse reactions. At 24 and 48 hours after surgery, SaO2 and PaO2 in the combined group were higher than those in sufentanil group （P 〈 0.05 ）. PaCO2 in the combined group was lower than that in the dezocine group and the sufentanil group （P 〈 0.05 ）. Conclusion Dezocine combined with sufentanil is a more efficiency way with less adverse reaction on postoperative anal- gesia for spinal deformity surgery, and it is an ideal way of analgesia.