地佐辛复合曲马多超前镇痛在高龄腹腔镜手术中的应用效果分析

The Application Value of Preemptive Analgesia with Dezocine Combined with Tramadol in Elderly Laparoscopic Surgery

目的分析地佐辛复合曲马多超前镇痛在高龄腹腔镜手术中的应用效果。方法选取2016年1月-2018年2月于我院行腹腔镜手术的86例高龄患者为受试对象,按照入院顺序随机分为复合组与对照组各43例。复合组于手术前注射地佐辛与曲马多,对照组则注射等量生理盐水。观察两组患者气管插管前(T1)、插管后30min(T2)、拔管后30min(T3)时血流动力学指标[心率(HR)、平均动脉压(MAP)]变化,比较两组患者术后30min、2h时舒适度[Bruggrmann舒适度评分标准(BCS)]、疼痛度[视觉模拟法疼痛评分标准(VAS)]差异,分析两组患者术后2d内药物不良反应发生情况。结果T1时两组HR、MAP比较均无统计学意义(P均>0.05);T2、T3时,复合组HR较T1时无明显变化(P均>0.05),而对照组HR水平显著升高(P均<0.05);T2、T3时,两组MAP水平均较T1时显著升高,且复合组变化幅度明显小于对照组(P均<0.05)。术后30min时,复合组BCS评分明显高于对照组,而VAS评分明显低于对照组(P均<0.05)。术后2h时,复合组BCS、VAS评分均较术后30min时无明显变化(P均>0.05);而对照组BCS评分较术后30min有明显降低,且VAS评分有明显升高(P均<0.05)。术后2d内,两组药物不良反应发生率比较均无统计学意义(P均>0.05)。结论地佐辛复合曲马多超前镇痛应用于高龄腹腔镜手术中可提升患者治疗体验,有利于术后恢复。

Objective To analyze the application effects of preemptive analgesia with dezocine combined with tramadol in elderly laparoscopic surgery.Methods 86 elderly patients who underwent laparoscopic surgery in the hospital from January 2016 to February 2018 were selected for the study and were randomly divided into combined group and control group according to the order of admission.Combined group was injected with dezocine and tramadol before surgery,and control group was injected with the same amount of normal saline.The changes of hemodynamics indexes[heart rate(HR),mean arterial pressure(MAP)]were observed in the two groups before tracheal intubation(T1),at 30 min after intubation(T2)and at 30 min after extubation(T3).The comfort[Bruggrmann comfort score(BCS)]and pain[visual analogue pain score(VAS)]were compared between the two groups at 30min and 2h after surgery,and the occurrence of adverse drug reactions was analyzed in the two groups within 2d after surgery.Results There were no significant differences in the HR and MAP between the two groups at T1(all P>0.05).At T2 and T3,the HR in combined group was not changed significantly compared with that at T1(P>0.05),but the HR level in control group was increased significantly(P<0.05).At T2 and T3,the MAP levels in the two groups were significantly increased compared with those at T1,and the change in combined group was significantly smaller than that in control group(P<0.05).At 30min after surgery,the BCS score in combined group was significantly higher than that in control group while the VAS score was significantly lower than that in control group(all P<0.05).At 2h after surgery,the scores of BCS and VAS in combined group were not changed significantly compared with those at 30min after surgery(all P>0.05).The BCS score in control group was significantly decreased compared with that at 30min after surgery while the VAS score was significantly increased(all P<0.05).Within 2d after surgery,there was no significant difference in the incidence rate of adverse drug reactions between the two groups(all P>0.05).Conclusion Preemptive analgesia with dezocine combined with tramadol can improve the treatment experience of patients and is conducive to prognosis and recovery in elderly laparoscopic surgery.