地佐辛与酮咯酸氨丁三醇在颈髓过伸伤的镇痛效果比较

Analgesic effect of dezocine and ketorolac tromethamine in patients with different degree of pain in the cervical spinal cord extension injury

目的回顾性分析比较地佐辛与酮咯酸氨丁三醇在颈髓过伸伤中不同疼痛程度的患者的镇痛效果,指导合理选择镇痛药物。方法回顾性分析2012年12月至2015年12月解放军第98医院80例颈髓过伸伤出现痛觉过敏患者的病历资料,以长海痛尺评分评定患者疼痛程度,长海痛尺评分≥3分为用药指征,随机分为观察组和对照组,观察组给于地佐辛7.5 mg肌注,对照组给于酮咯酸氨丁三醇60 mg肌注,比较2组对于不同疼痛程度患者用药后疼痛评分情况,3分以下为有效,≥3分为无效镇痛,并观察2组用药后发生的不良反应情况。结果从镇痛有效率比较,2组用药30 min后,中重度疼痛,观察组有效率100.0%,对照组有效率94.7%,差异无统计学意义(P>0.05),均为有效镇痛。剧烈以上疼痛,观察组镇痛有效率95.0%,对照组有效率仅为42.9%,差异有统计学意义(P<0.01),地佐辛镇痛效果优于酮咯酸氨丁三醇。从镇痛前后疼痛评分比较,2组在中重度疼痛镇痛后评分差异无统计学意义(P>0.05);观察组与对照组剧烈以上疼痛镇痛后评分分别为(1.32±0.99)、(3.40±2.20),差异有统计学意义(P<0.05)。观察组药品不良反应发生率(20.0%)高于对照组(7.5%),差异有统计学意义(P<0.05)。结论在颈髓过伸伤的镇痛治疗中,中重度疼痛可选择地佐辛或酮咯酸氨丁三醇,剧烈以上疼痛地佐辛镇痛效果明显优于酮咯酸氨丁三醇,但地佐辛不良反应率较高,因此临床用药上建议根据疼痛评分来合理选择镇痛药。

Objective A retrospective analysis was used to compare analgesic effect of dezocine and ketorolac tromethamine in patients with different degree of pain in the cervical spinal cord extension injury,and to guide a reasonable choice of analgesic drug.Methods A retrospective analysis was performed from December 2012 to December 2015 in the 98 th Hospital of PLA,including 80 cases of cervical hyperextension injury in patients with allergic pain in medical records. The degree of pain was evaluated in patients with Changhai pain scale score. Changhai pain scale of more than 3 points was for the indications of drug use,and were randomly divided into observation group and control group.The observation group was given dezocine 7.5mg,and the control group was given ketorolac ammonia butyl alcohol three 60 mg with intramuscular injection. Pain score was compared with two groups（ less than 3 points for the effective,more than 3 points for invalid analgesia）,and adverse reactions occurred in the two groups after treatment was observed.Results Compared with the effective rate of analgesia,the two groups after treatment with 30 min in moderate and severe pain patients,the effective rate of the observation group was 100%,the effective rate of the control group was 94.7%,and there was no statistically significant difference（ P〈0.05）. For more severe pain,the effective rate of the observation group was 95%,the efficiency of the control group was 42.9%,and the difference was statistically significant（ P〈0.01）. Dezocine analgesia effect was better than that of ketorolac tromethamine. From the comparison of pain scores before and after analgesia,observation group and control group with the moderate to severe pain was not significant different（ P〈0.05）; severe pain after the above scores were（ 1.32±0.99）,（ 3.40±2.20）,the difference was statistically significant（ P〈0. 05）. The incidence of adverse drug reactions in the observation group was 20. 0%,which was higher than that in the control group（ 7.5%）,and the difference was statistically significant（ P〈0.05）. Conclusion In analgesic treatment of the cervical spinal cord with extension injury,patients with moderate to severe pain can choose dezocine or ketorolac tromethamine. For patients with severe pain,dezocine analgesia was significantly better than that of ketorolac tromethamine,but dezocine adverse reaction rate ishigher,the clinic should choose reasonable analgesic drug according to pain score,both to achieve effective analgesia,and minimum adverse drug reactions.