舒芬太尼复合地佐辛用于痔上黏膜环切术后自控镇痛的临床研究

Clinical Study on Sufentanil Combined with Diazocine for Postoperative Patient-controlled Analgesia in Procedure for Prolapse and Hemorrhoids

目的:探讨舒芬太尼复合地佐辛用于吻合器痔上黏膜环切术(PPH)术后静脉自控镇痛(PCIA)的临床效果及不良反应。方法:选取2016年1月-2017年12月本院收治的100例混合痔择期行PPH患者。按照入院顺序的奇偶数分为对照组和观察组,各50例。观察组采用舒芬太尼复合地佐辛行术后PCIA,对照组给予单纯舒芬太尼行术后PCIA。观察并记录两组术后6 h(T1)、12 h(T2)、24 h(T3)、48 h(T4)静息状态与翻身运动时疼痛视觉模拟评分(VAS)、Ramsay镇静评分(RSS)、舒适评分(BCS)以及不良反应。结果:两组术后各时间点VAS、RSS评分均较低,但两组间比较差异均无统计学意义(P>0.05);T1、T2、T3时,两组BCS评分比较差异均无统计学意义(P>0.05),但T4时,观察组BCS评分明显高于对照组,比较差异有统计学意义(P<0.05);观察组术后不良反应发生率为8.0%,明显低于对照组的28.0%,比较差异有统计学意义(P<0.05)。结论:舒芬太尼复合地佐辛用于PPH术后PCIA,其镇痛、镇静效果与单纯使用舒芬太尼的效果相当,但前者术后48 h患者的舒适度优于后者,不良反应的总发生率则低于后者,在PPH术后PCIA中应用价值较高。

Objective：To evaluate the clinical effect and adverse reactions of Sufentanil combined with Diazocine on postoperative patient-controlled intravenous analgesia（PCIA） in procedure for prolapse and hemorrhoids（PPH）.Method：100 patients suffered from mixed hemorrhoids and scheduled for selective PPH in our hospital from January 2016 to December 2017 were selected.According to the order of admission,they were divided into the control group and the observation group,50 cases in each group.The observation group was treated with Sufentanil combined with Dezocine for postoperative PCIA,while control group was given Sufentanil only for postoperative PCIA.The visual analogue scale（VAS） both of resting and turning over movement,ramsay sedation score（RSS）,bruggrmann comfort score（BCS） and adverse reactions at 6 h（T1）,12 h（T2）,24 h（T3） and 48 h（T4） after surgery were observed and recorded for the two groups.Result：The VAS and RSS scores of the two groups at each time point after operation were lower,but the two groups were compared,the differences were not statistically significant（P〉0.05）.At T1,T2,T3,the BCS scores of two groups were compared,the differences were not statistically significant（P〉0.05）,While at T4,the BCS score of the observation group was significantly higher than that of the control group,the difference was statistically significant（P〈0.05）.The incidence of adverse reactions in the observation group（8.0%） was significantly lower than that of control group（28.0%）,the difference was statistically significant（P〈0.05）.Conclusion：Sufentanil combined with Dezocine is equivalent to Sufentanil alone in postoperative PCIA and sedation in PPH,however at 48 hours after surgery,the comfort of the former is superior to that of the latter.Moreover,the incidence of adverse reactions in the former is lower than that of the latter.Sufentanil combined with Dezocine has higher value in PCIA after PPH.