不同浓度地佐辛联合舒芬太尼用于剖宫产术后镇痛的效果

Effects of different concentrations of dezocine combined with sufentanil on postoperative analgesia after Cesarean section

目的观察不同浓度地佐辛联合舒芬太尼用于剖宫产术后的镇痛效果。方法初产、单胎、足月妊娠拟行剖宫产孕妇90例。在剖宫产手术结束后对产妇安装静脉自控镇痛泵，采用随机单盲法将其分为3组：舒芬太尼均为1．5μg／kg，托烷司琼均为0．15mg／kg，地佐辛0．15mg／kg组30例（D1组）；地佐辛0.3mg／kg组30例（D2组），地佐辛0．45mg／kg组30例（D3组），分别以0．9％氯化钠稀释至100ml，D2、D3组其他成分同D1组。于术后6、12、24、36、48h时记录VAS评分、Ramsay评分及恶心呕吐（PONV）评分等不良反应。结果术后6、12、24、36、48h时的VAS镇痛评分D1组最高，D3组最低且差异有统计学意义（P〈0.05）。术后6、12、24、36、48h时的Ramsay镇静评分和PONV评分中均D3组最高，D1组最低且差异均有统计学意义（P〈0.05）；D2组不良反应较少（P〈0．05）。结论地佐辛联合舒芬太尼在剖宫产术后镇痛时发挥镇痛作用较佳与不良反应较少的地佐辛适宜浓度为0．3mg／kg稀释至100ml。

Objective To investigate the effects of different concentrations of dezocine combined with sufentanil in patient-controlled intravenous analgesia （PCIA）after Cesarean section, Methods A total of 90 parturients underwent Cesarean section under combined spinal and epidural anesthesia were included in this study. The parturients were randomly and single-blindly divided into 3 groups： group D1 with sufentanil 1.5 μg/kg, tropisetron hydrochloride 0.15 mg/kg and dezocine 0.15 mg/kg; group D2 and D3 with dezocine 0.3 mg/kg and 0.45 mg/kg diluted to 100 ml with normal saline respectively, dosage of sufentanil and tropisetron in accordance with group D1. Results The highest of VAS was in group D1 and lowest in group D3 at 6, 12, 24, 36 and 48 h after the operation （P〈0.05）. The highest of Ramsay sedation score and PONV score were in group D3 and lowest in group D1 at 6, 12, 24, 36 and 48 h after the operation （P〈0.05）. The fewest of adverse reactions was in group D2 （P〈0.05）. Conclusion Moderate concentration （0.3mg/kg in normal saline 100 ml） dezocine combined with sufentanil can significantly improve the sedation and analgesia effects of patient-controlled intravenous analgesia （PCIA） after Cesarean section and the adverse reactions are the fewest.