探讨舒芬太尼联合地佐辛在上腹部手术后自控镇痛中的临床效果

Study on Clinical Effect of Sufentanil and Dezocine in the Patient-controlled Analgesia of Upper Abdominal Surgery

目的探讨分析舒芬太尼联合地佐辛在上腹部手术后自控镇痛中的临床效果。方法方便选取该院自2015年1月—2016年12月这一段期间内收治的需行上腹部手术的患者122例作为临床研究对象,以随机对照分组法将其平均分成两组,一组作为观察组,一组作为对照组,各61例,两组均行气管插管全身麻醉,术中注射昂丹司琼,于手术结束前10 min时,对观察组采用舒芬太尼+地佐辛+昂丹司琼行自控静脉镇痛,对照组采用舒芬太尼+昂丹司琼行自控静脉镇痛,分别在术后2、6、12、24、48 h时观察比较两组患者的视觉模拟评分(VAS评分)、镇静评分、自控镇痛次数及不良反应发生率。结果术后2、6 h及术后12 h时两组患者的VAS评分均呈显著上升趋势(P<0.05);术后24 h和术后48 h时两组患者的VAS评分均呈显著下降趋势(P<0.05);术后2、6、12、24、48 h时观察组患者的VAS评分均显著低于对照组患者(P<0.05)。术后2、6、12 h及术后24 h时两组患者的镇静评分均呈显著上升趋势(P<0.05),术后48 h时两组患者的镇静评分均呈显著下降趋势(P<0.05);术后2、6、12、24、48 h时观察组患者的镇静评分均显著低于对照组患者(P<0.05)。术后2、6、12、24、48 h时两组患者的自控镇痛次数均呈显著下降趋势(P<0.05);术后2、6、12、24、48h时观察组患者的自控镇痛次数均显著少于对照组患者(P<0.05)。观察组患者的不良反应发生率(8.2%)显著低于对照组患者(39.3%)(P<0.05)。结论舒芬太尼联合地佐辛在上腹部手术后自控镇痛中应用不但镇痛效果显著,且安全性高,不良反应较少,可于临床上推广应用。

Objective To study the clinical effect of sufentanil and dezocine in the patient-controlled analgesia of upper abdominal surgery. Methods Convenient selection 122 cases of patients needing the upper abdominal surgery admitted and treated in our hospital from January 2015 to December 2016 were selected and randomly divided into two groups with 61 cases in each, both groups adopted the tracheal cannulation general anesthesia and were injected with ondansetron in operation, and the observation group adopted the sufentanil and dezocine and ondansetron for the patient-controlled analgesia,while the control group adopted the sufentanil and ondansetron for the patient-controlled analgesia, and the VAS score,calm score, patient-controlled analgesia and incidence rate of adverse reactions at 2, 6, 12, 24, 48 h after operation of the two groups were observed. Results The VAS score showed an obvious increasing trend at 2, 6 h and 12 h after operation（P〈0.05）, and the VAS score showed an obvious decreasing trend at 24 h and 48 h after operation（P〈0.05）, and the VAS scores at 2, 6, 12, 24 h and 48 h after operation were obviously lower than those in the control group（P〈0.05）, and the calm scores at 2, 6, 12, 24 h and 48 h after operation showed an obvious increasing trend（P〈0.05）, and the calm score of the two groups at 48 h after operation showed an obvious decreasing trend（P〈0.05）, and the calm scores at 2, 6, 12, 24 h and 48 h after operation were obviously lower than those in the control group（P〈0.05）, and the patient-controlled analgesia time at 2, 6,12, 24 h and 48 h after operation showed an obvious increasing trend, and the patient-controlled analgesia times at 2, 6,12, 24 h and 48 h after operation in the observation group were obviously fewer than those in the control group（P〈0.05）, and the incidence rate of adverse reactions in the observation group was obviously lower than that in the control group（8.2% vs39.3%）（P〈0.05）. Conclusion The effect of sufentanil and dezocine in the Patient-controlled analgesia of upper abdominal surgery is obvious with high safety and few adverse reactions, which can be promoted and applied in clinic.