妇科下腹部术后不同剂量地佐辛与吗啡镇痛效果的临床研究

Clinical Study on the Analgesic Effect of Different Doses of Dextrozine and Morphine after Gynecological Lower Abdomen Operation

目的评价地佐辛和吗啡在下腹部妇科传统开腹术后镇痛作用和安全。方法方便收集苏州大学附属第二医院2013年4月—2015年12月120例全麻下妇科下腹部手术治疗的患者,随机分为地佐辛低剂量组(D1),地佐辛高剂量组(D2)及吗啡组(M),进行静脉自控镇痛(PCIA),每组40例。观察术后4、8、16、24、48 h的镇静评分(Ram say)、镇痛评分(VAS),肛门恢复排气时间,生命体征情况及不良反应发生情况。结果 3组患者术后Ramsay及VAS评分比较差异无统计学意义(P>0.05)。3组患者镇痛过程中各时间点平均动脉压(MAP)、心率(HR),呼吸率(RR)、血氧饱和度(SpO2)生命体征变化差异无统计学意义(P>0.05)。M组不良反应发生率高于D1、D2组。M组发生皮肤瘙痒较D1、D2组高,差异有统计学意义(P<0.01)。吗啡组恶心呕吐率明显高于地佐辛低剂量组,差异有统计学意义(P<0.05)。地佐辛低剂量组(D1)(28.43±5.43)min术后肛门恢复排气时间短于地佐辛高剂量组(D2)(37.71±6.78)min及吗啡组(M)(35.42±6.19)min(P<0.05)。结论地佐辛对妇科开腹后镇痛治疗有效安全。地佐辛和吗啡镇痛效果一致,而各项不良反应显著减少。地佐辛低剂量组肛门恢复排气时间短于高剂量组和吗啡组。

Objective To evaluate the analgesic effect and safety of dizocine and morphine in the lower abdominal gyneco- logical traditional open surgery. Methods A total of 120 patients underwent general anesthesia underwent gynecological lower abdominal surgery from April 2013 to December 2015 were convenient selected in the Second Affiliated Hospital of Soochow University. The patients were randomly divided into the low dose group of dizocine （D1） and the high dose group of dizocine （D2）, and morphine group （M）, intravenous analgesia （PCIA）, 40 cases in each group. The sedation scores （Ram say）, analgesia score （VAS）, anal recovery time, vital signs and adverse reactions were observed at 4, 8, 16, 24, and 48 h after surgery. Results There were no significant differences in Ramsay and VAS scores between the three groups （P〉0.05）. There were no significant differences in mean arterial pressure （MAP）, heart rate （HR）, respiration rate （RR）, and oxygen saturation （SpO2） between the three groups at the time of analgesia （P〉0.05）. The incidence of side effects in group M was higher than that in group D1. Skin itching in group M was higher than that in D1 and D2 group,the difference was statistically signficant （P〈0.01）. The nausea and vomiting rate in the morphine group was significantly higher than that in the low dose group of dizocine,the difference was statistically signficant（P〈0.05）. In the low-dose group （D1） （28.43±5.43）rain, the anal recovery time was shorter than that of the high dose group （D2） （37.71±6.78）rain and morphine group （M） （35.42±6.19） rain,the difference was statistically signficant（P〈0.05）. Conclusion Dizocine was effective and safe for gynecological analgesia after laparotomy. The analgesic effect of dizocine and morphine was consistent, and the adverse reactions were significantly reduced. The anesthesia recovery time of the low dose group of dizocine was shorter than that of the high dose group and the morphine group.