地佐辛超前镇痛在肛肠手术患者中的应用研究

Application of Dezocine in Preemptive Analgesia for the Patients Undergoing Anorectal Disease Surgery

为探讨术前肌肉注射地佐辛超前镇痛用于肛肠手术的效果及安全性,将80例择期行肛肠手术的患者随机分为观察组和对照组,各40例,观察组术前10min肌肉注射地佐辛10mg,对照组术前肌肉注射0.9%生理盐水2mL,分别于术后1 h、2h、4h、6h对创口疼痛情况进行评分,评分≥4分者,予哌替啶100mg肌肉注射,记录2组患者术后使用哌替啶的病例数和初次使用时间,以及术后导尿率和恶心呕吐、头晕嗜睡、呼吸抑制等不良反应发生率.结果显示,观察组术后1h、2h、4h、6 h疼痛评分及术后哌替啶使用率、导尿率均明显低于对照组,术后哌替啶首次使用时间明显晚于对照组,差异均有统计学意义,P〈0.05或P〈0.01.2组术后恶心呕吐、头晕嗜睡、呼吸抑制发生率比较差异均无统计学意义,P〉0.05.结果表明,术前肌肉注射地佐辛超前镇痛用于肛肠手术,可有效减轻患者术后创口疼痛程度,减少镇痛药使用量,降低尿潴留发生率,且不增加不良反应发生率.

This study was to explore the efficacy and safety of preoperatively intramuscular injecting dezocine for preemptive analgesia of anorectal disease surgery,randomly divided 80 cases to be subject to sched- uled anorectal disease surgery into observation group and control one, 40 cases for each; which the former received intramuscular iniection of dezocine 10 mg at 10 min before surgery, meanwhile the latter 0.9% normal saline of 2 mL;then at 1,2,4 and 6 h after surgery took the score on wound pain,when rating points ≥4,injecting intramuscularly pethidine 100 rag, recorded following data： case-number using pethidine,as well as their first using time; postoperative urethral catheterization rate;and incidence of nausea vomiting, dizziness 8~ sleepiness, breathing suppression, etc adverse reaction.As results,in the score on pain at 1,2,4 and 6 hr. after surgery, the rate of using pethidine,and urethral catheterization rate,in first using pethidine time after surgery,the former was all significantly lower,later than the latter,there was statisti- cal difference （ P 〈0.05 or P 〈0.01） ,but there was no statistical difference between both groups in the incidence of nausea 8〈 vomiting,dizziness 8〈 sleepiness,breathing suppression （ P 〈0.05）.Results show that preoperatively intramuscular injecting dezocine as preemptive analgesia for anorectal surgery can effectively alleviate pain degree of wound, reduce dosage of analgesia agent,lower incidence of uroschesis,without ad- verse reaction incidence increasing.