不同剂量地佐辛复合舒芬太尼用于腹腔镜卵巢囊肿剔除术的镇痛效果及对血清5-HT和PS的影响

Analgesia Effect of Different Doses of Dezocine Combined with Sufentanil in Application of Laparoscopic Ovarian Cyst Exclusion and Its Effects on Serum 5-HT and PS Levels

目的探讨不同剂量地佐辛复合舒芬太尼用于腹腔镜卵巢囊肿剔除术的镇痛效果及对血清5-羟色胺(5-HT)和P物质(PS)的影响。方法回顾性分析2013年1月—2016年10月诊治的120例行腹腔镜卵巢囊肿剔除术患者的临床资料。根据地佐辛剂量的不同分为A组(给予舒芬太尼2μg/kg、地佐辛0.1 mg/kg等药物镇痛)、B组(给予舒芬太尼1μg/kg、地佐辛0.2 mg/kg等药物镇痛)和C组(给予舒芬太尼1μg/kg、地佐辛0.3 mg/kg等药物镇痛),每组40例。比较并观察3组术后4、12、24和48 h的Ramsay镇静评分、视觉模拟评分法(VAS)评分、舒适度量表(BCS)评分,比较治疗前及术后12、24和48 h血清5-HT、PS水平,并比较不良反应发生情况等。结果术后4、12和24 h,C组VAS、Ramsay镇静评分均低于A组和B组,且B组低于A组(P<0.05);C组BCS评分均高于A组和B组,且B组高于A组(P<0.05)。术后12、24和48 h,3组血清5-HT、PS水平高于治疗前(P<0.05),且C组低于A组和B组,B组低于A组(P<0.05)。A组不良反应总发生率明显高于B组和C组(P<0.05)。结论地佐辛0.3 mg/kg复合舒芬太尼1μg/kg用于腹腔镜卵巢囊肿剔除术患者的镇痛效果最为显著,可有效减轻术后疼痛,并能对术后血清5-HT和PS水平产生明显抑制作用,且安全可靠。

Objective To investigate analgesia effect of different doses of Dezocine combined with Sufentanil in application of laparoscopic ovarian cyst exclusion and its effects on serum5-hydroxytryptamine(5-HT)and P surfactant(PS)levels.Methods Clinical data of120patients undergoing laparoscopic ovarian cyst exclusion admitted during January2013and October2016was retrospectively analyzed,and the patients were divided into group A(analgesia with2μg/kg Sufentanil,0.1mg/kg Dezocine and other drugs,n=40),group B(analgesia with1μg/kg Sufentanil,0.2mg/kg Dezocine and other drugs,n=40)and group C(analgesia with1μg/kg Sufentanil,0.3mg/kg Dezocine and other drugs,n=40)according to different doses of Dezocine.Among3groups,Ramsay sedation scores,visual analogue scales(VAS)scores and bruggrmann comfort scale(BCS)scores at4th,12th,24th and48th h after treatment were observed and compared,and serum5-HT and PS levels before and at12th,24th and48th h after treatment and incidence rates of adverse reaction were compared.Results At4th,12th and24th h after treatment,VAS and Ramsay sedation scores in group C were significantly lower than those in group A and B,and the scores in group B were significantly lower than those in group A(P<0.05);BCS scores in group C were significantly higher than those in group A and B,and the scores in group B were significantly higher than those in group A(P<0.05).After12th,24th and48th h after treatment,serum5-HT and PS levels were significantly higher than those before treatment among3groups(P<0.05),and the levels in group C were significantly lower than those in group A and B,and the levels in group B were significantly lower than those in group A(P<0.05).The total incidence rate of adverse reactions in group A was significantly higher than that in group B and C(P<0.05).Conclusion The effect of0.3mg/kg Dezocine combined with1μg/kg Sufentanil in analgesia of patients after laparoscopic ovarian cyst exclusion is the most significant,and it can effectively reduce postoperative pain,and significantly inhibit serum5-HT and PS levels after operation with safe.