3种剂量舒芬太尼联合地佐辛用于择期髋关节置换术后镇静镇痛效果比较

Effects of 3 Different Doses of Sufentanil Combined with Dezocine on Sedation and Analgesia After Selective Hip Replacement

目的比较3种剂量舒芬太尼联合地佐辛用于择期髋关节置换术后镇静镇痛的效果。方法选择医院2014年7月至2016年7月收治的择期行髋关节置换术患者180例,按随机区组法分为A组、B组及C组,各60例,术后分别给予1.0,1.5,2.0μg/kg舒芬太尼联合地佐辛,比较3组患者术后疼痛视觉模拟评分(VAS)和Ramsay镇静评分,镇痛药物加用情况及不良反应发生情况。结果 B组和C组患者术后1,4,12 h VAS评分均显著高于A组(P<0.05);3组患者术后Ramsay评分比较,差异无统计学意义(P>0.05);A组患者镇痛药物加用率和加用量均显著低于B组和C组(P<0.05);A组和B组患者不良反应发生率均显著低于C组(P<0.05)。结论舒芬太尼联合地佐辛用于择期髋关节置换术后镇静镇痛效果确切,且舒芬太尼选用1.5μg/kg剂量时效果更佳,不良反应发生率低,值得临床推广。

Objective To compare the effects of 3 different doses of sufentanil combined with dezocine on sedation and analgesia after selective hip replacement. Methods Totally 180 patients underwent selective hip replacement from January 2014 to June 2016 in our hospital were selected and randomly divided into group A, group B and group C, 60 cases in each group. The patients in the three groups were given 1. 0,1. 5,2. 0 μg/kg of sufentanil combined with dezocine. The postoperative VAS score and Ramsay sedation score,the addition of analgesic drugs and the incidence of adverse reactions of the 3 groups were compared. Results 1,4,12 h after operation,the VAS scores of group B and group C was significantly lower than those of group A（ P〈0. 05）. After operation,there was no significant difference in Ramsay scores among the 3 groups（ P〉0. 05）. The addition rate of analgesic drugs and amount of remedial analgesia of group A were significantly higher than those in group B and group C（ P〈0. 05）. The incidence rates of adverse reactions in group A and group B were significantly lower than that in group C（ P〈0. 05）. Conclusion Sufentanil combined with dezocine has good sedation and analgesia effect for selective hip replacement, and sufentanil with 1. 5 μg/kg dose has better effect, lower incidence rate of adverse reactions,it is worthy of clinical promotion.