地佐辛复合氟比洛芬酯或芬太尼在开胸术后镇痛中的应用比较

Dezocine combined with flurbiprofen or fentanyl for postoperative analgesia after thoracic surgery

目的研究对比地佐辛复合氟比洛芬酯或芬太尼在开胸术后镇痛中的应用效果。方法选2015年1月至2016年1月接受开胸手术的患者150例。均分为A、B两组,所有患者术后均进行自控静脉镇痛,A组患者使用地佐辛与芬太尼予以镇痛,B组患者则用地佐辛与氟比洛芬酯镇痛。对比患者术后2、4、8、24 h的VAS疼痛评分、Prince-Henry疼痛评分、Ramasy镇静评分及术后24 h PCA按压次数与不良反应。结果 A组术后2、4 h VAS评分、Prince-Henry疼痛评分均高于B组,A组术后2 h的Ramasy镇静评分高于B组,而术后4、8、24 h低于B组,差异有统计学意义(P<0.05)。A组术后24 h PCA按压次数低于B组(P<0.05);A组不良反应发生率高于B组(P<0.05)。结论地佐辛复合氟比洛芬酯应用于开胸术后镇痛效果较好,而地佐辛复合芬太尼术后最初数小时镇痛效果并不理想,容易产生不良反应。

Objective To study the effects of dezoeine combined with flurbiprofen or fentanyl for postoperative analgesia after thoracic surgery. Methods One hundred and fifty patients accepted thoracic surgery from January of 2015 to January of 2016 were selected and divided into group A and group B. Postoperative patient - controlled intravenous analgesia was performed in all patients. Group A was treated with dezocine and fentanyl for analgesia, group B was treated with dezocine and flurbiprofen anal- gesia. VAS score, Prince - Henry pain score, Ramasy sedation score and 24 h PCA compression times and adverse reactions af- ter surgery were compared. Results The results showed that 2, 4 h after operation, the VAS pain score, Prince - Henry pain scores of group A were higher than those of group B, and 2 h after operation, postoperative Ramasy sedation score of group A was higher than that of group B, and 4, 8, 24 h after operation lower than group B, and the differences were statistically significant （ P 〈 0. 05 ）. 24 h PCA press times and adverse reactions were compared between the three groups after operation, and the differences were statistically significant （ P 〈 0. 05 ）. Conclusion The effect of dezocine combined with flurbiprofen is good in postoperative analgesia after thoracic surgery, and the effect of dezocine combined with fentanyl for postoperative analgesia in the first few hours is not ideal, prone to adverse reactions.