不同剂量地佐辛加舒芬太尼在经皮肾镜碎石取石术术后自控静脉镇痛中的应用效果观察

The application effect of different doses of sufentanil and dezocine on self controlled intravenous analgesia after percutaneous nephrolithotomy with lithotripsy

目的对不同剂量地佐辛加舒芬太尼在经皮肾镜碎石取石术术后自控静脉镇痛中的应用效果进行研究及判定。方法选取于2015年1月~2016年7月在粤东医院行经皮肾镜碎石取石术术后自控静脉镇痛的100例患者,依据麻醉药物的不同剂量将其进行划分,其中给予舒芬太尼[1μg/(kg·d)]、地佐辛[0.05μg/(kg·d)]的患者33例,作为A组,给予舒芬太尼[1μg/(kg·d)]、地佐辛[0.1μg/(kg·d)]的患者34例,作为B组,给予舒芬太尼[1μg/(kg·d)]、地佐辛[0.2μg/(kg·d)]的患者33例,作为C组,自控静脉镇痛剂量设置为:2.5m L/h背景剂量,2m L/次自控剂量,20min的锁定时间,并对A、B、C三组不同剂量麻醉药物使用的患者的Ramsay评分(镇静程度评分)、BCS评分(舒适程度评分)及不良反应情况进行记录并分析。结果 A组经皮肾镜碎石取石术患者经麻醉后,其BCS评分(舒适程度评分)较B、C两组低,P<0.05,其C组的Ramsay评分(镇静程度评分)高于A、B两组,但不良反应发生率亦较A、B两组高,P<0.05,A组相比于其他两组Ramsay评分(镇静程度评分)较低,及B组的不良反应发生率更少,P<0.05。结论综合考虑,给予舒芬太尼[1μg/(kg·d)]、地佐辛[0.1μg/(kg·d)]的剂量进行自控静脉镇痛,为较为安全及稳定的治疗方案,但须结合实际情况给予相应的剂量调整,以获得更好的麻醉效果。

Objective To study and judge the application effect of different doses of sufentanil and dezocine on self controlled intravenous analgesia after percutaneous nephrolithotomy with lithotripsy.Methods One hundred patients with self controlled intravenous analgesia after percutaneous nephrolithotomy with lithotripsy in Yuedong Hospital from January 2015 to July 2016 were selected.According to the different doses of narcotic drugs,33 patients who were given sufentanil(1μg/kg/d)and dezocine(0.05μg/kg/d)were selected as group A.34 patients who were given sufentanil(1μg/kg/d)and dezocine(0.1μg/kg/d)were selected as group B.33 patients who were given sufentanil(1μg/kg/d)and dezocine(0.2μg/kg/d)were selected as group C.The dosage of self controlled intravenous analgesia was set as:2.5 mL/h background dose,2 mL/time self controlled dose,20 min locking time.The Ramsay score(sedation score),BCS score(comfort score)and adverse reactions of three groups of A,B and C groups were compared and analyzed.Results After anaesthesia,the BCS score(comfort score)in group A was lower than that in group B and C(P<0.05),and the Ramsay score(sedation score)in group C was higher than that in group A and B,but the incidence of adverse reactions was also higher than that of group A and B(P<0.05).Compared with the other two groups,the Ramsay score(sedation score)of group A was lower,and the incidence of adverse reactions in group B was less,P<0.05.Conclusion The application of sufentanil(1μg/kg/d)and dezocine(0.1μg/kg/d)dose is a safer and stable treatment plan,but the dose adjustment should be adjusted according to the actual situation,so as to achieve better anesthetic effect.