不同剂量地佐辛复合舒芬太尼应用于腹腔镜腹部手术对应激反应的影响

Effect of different doses of dezocine combined with sufentanil on stress response in laparoscopic abdominal surgery

目的:探究不同剂量地佐辛复合舒芬太尼用于腹腔镜腹部手术对患者应激反应的影响。方法:2017年9月-2019年3月收治择期行腹腔镜腹部手术的患者120例,随机分为三组,各40例。三组患者术后均采用静脉镇痛泵,A组应用舒芬太尼2μg/kg;B组应用舒芬太尼1μg/kg+地佐辛0.2mg/kg;C组应用舒芬太尼1μg/kg+地佐辛0.3mg/kg。比较三组患者术前(T0)、术后1h(T_(1))、术后4h(T_(2))、术后24h(T_(3))去甲肾上腺素(NE)、肾上腺素(E)及皮质醇(Cor)水平;记录三组患者T_(1)、T_(2)、T_(3)的视觉模拟评分(VAS)。结果:C组T_(1)、T_(2)、T_(3)时NE、E、Cor水平均低于A组和B组,差异有统计学意义(P<0.05);C组T_(1)~T_(3)的VAS评分均低于A组和B组,差异有统计学意义(P<0.05)。结论:舒芬太尼1μg/kg复合地佐辛0.3mg/kg用于腹腔镜腹部手术患者中的镇痛效果最为明显,可有缓解术后疼痛,减轻应激反应,利于促进术后恢复。

Objective:To explore the effect of different doses of dezocine combined with sufentanil on stress response in laparoscopic abdominal surgery.Methods:From September 2017 to March 2019,120 patients scheduled for laparoscopic abdominal surgery were selected and randomly divided into three groups with 40 cases in each group.Three groups of patients were treated with intravenous analgesia pump,Group A received sufentanil 2μg/kg,Group B received sufentanil 1μg/kg+dezocine 0.2 mg/kg,Group C received sufentanil 1μg/kg+dezocine 0.3 mg/kg.We compared the levels of norepinephrine(NE),epinephrine(E)and cortisol(COR)before operation(T0),1 hour after operation(T_(1)),4 hours after operation(T_(2))and 24 hours after operation(T_(3)).We recorded the visual analogue scale(VAS)of T_(1),T_(2) and T_(3) in the three groups.Results:In Group C,the levels of NE,E and Cor at T_(1),T_(2) and T_(3) were lower than those in Group A and Group B,the difference was statistically significant(P<0.05).In Group C,the VAS scores of T_(1)~T_(3) were lower than those of Group A and Group B,the difference was statistically significant(P<0.05).Conclusion:The analgesic effect of sufentanil 1μg/kg+dezocine 0.3 mg/kg is the most obvious in patients undergoing laparoscopic abdominal surgery,it can relieve postoperative pain,relieve stress reaction and promote postoperative recovery.