对比不同剂量瑞芬太尼与地佐辛联用对胃癌术后患者的镇痛效果

Comparison of Analgesic Effect of Different Doses of Remifentanil and Dezocine for Gastric Cancer Patients after Surgery

目的探究不同剂量的瑞芬太尼与地佐辛联用对胃癌术后的临床镇痛效果。方法以该院2015年1月—2016年12月诊治的100例胃癌手术患者为研究对象,根据患者的术后静脉镇痛等级分为A组与B组,每组患者50例。A组剂量为地佐辛0.2 mg/kg,瑞芬太尼0.4μg/kg,B组剂量为地佐辛0.3 mg/kg,瑞芬太尼0.1μg/kg;以自控静脉注射方式进行镇痛,对比两组患者手术前后的VAS疼痛评分、BCS舒适评分及不良反应发生状况。结果术后T1~T5内A组患者的VAS疼痛评分依次为(5.08±0.75)分、(4.51±0.54)分、(3.95±0.85)分、(3.71±0.24)分、(3.85±0.26)分,BCS评分依次为(1.52±0.52)分、(1.66±0.08)分、(1.85±0.08)分、(1.95±0.75)分、(1.88±0.54)分,B组患者T1~T5内VAS疼痛评分依次为(3.02±0.25)分、(3.05±0.15)分、(2.68±0.61)分、(2.45±0.14)分、(2.75±0.16)分,BCS评分依次为(2.85±0.94)分、(3.05±0.16)分、(2.95±0.23)分、(2.98±0.45)分、(2.96±0.45)分,两组比较,VAS评分A组高于B组,BCS评分A组低于B组差异有统计学意义(P<0.05),术后PCIA按压次数A组(6.2±1.5)次低于B组患者(13.8±2.5)次差异有统计学意义(P<0.05);A组患者恶心、呕吐等不良反应发生率为52.0%高于B组患者24.0%(P<0.05)。结论采用瑞芬太尼0.1μg/kg,地佐辛0.3 mg/kg的静脉镇痛方案对于胃癌术后患者的镇痛效果最佳,降低了不良反应发生率,安全性更高,可以推广。

Objective To study the analgesic effect of different doses of remifentanil and dezocine for gastric cancer patients after surgery.Methods 100 cases of gastric cancer patients diagnosed and treated in our hospital from January 2015 to December 2016 were selected as the research objects and divided into the group A and group B with 50 cases in each according to the postoperative intravenous analgesia level,the dose in the group A was dezocine 0.2 mg/kg and remifentanil 0.4μg/kg,and the dose in the group B was dezocine 0.3 mg/kg and remifentanil 0.1μg/kg,and the analgesia was performed by the self-controlled intravenous injection,and the VAS pain score,BCS comfort score and occurrence of adverse reactions of the two groups before and after operation were compared between the two groups.Results The VAS pain scores in the group A at T1-T5 after surgery were respectively(5.08±0.75)points,(4.51±0.54)points,(3.95±0.85)points,(3.71±0.24)points,(3.85±0.26)points and the BCS scores were respectively(1.52±0.52)points,(1.66±0.08)points,(1.85±0.08)points,(1.95±0.75)points,(1.88±0.54)points and the VAS scores in the group B at T1-T5 after surgery were respectively(3.02±0.25)points,(3.05±0.15)points,(2.68±0.61)points,(2.45±0.14)points,(2.75±0.16)points and the BCS scores were respectively(2.85±0.94)points,(3.05±0.16)points,(2.95±0.23)points,(2.98±0.45)points,(2.96±0.45)points,and the VAS score in the group A was higher than that in the group B,and the BCS score in the group A was lower than that in the group B,the difference was statistically significants(P<0.05),and the pressing time of PCIA after surgery in the group A was lower than that in the group B[(6.2±1.5)times vs(13.8±2.5)times]the difference was statistically significants(P<0.05),and the incidence rate of nausea and vomiting in the group was higher than that in the group B(52.0%vs 24.0%)the difference was statistically significants(P<0.05).Conclusion The intravenous analgesia plan of 0.1μg/kg remifentanil and 0.3mg/kg dezocine can have a better effect on the gastric cancer patients after surgery and reduce the incidence rate of adverse reactions with high safety,and it can be promoted.