地佐辛与舒芬太尼在小儿腹腔镜术后镇痛、躁动及应激反应的影响对比

Comparison of the effects of dezocine and sufentanil on analgesia,agitation,and stress response after pediatric laparoscopic surgery

目的:比较地佐辛与舒芬太尼对小儿腹腔镜术后镇痛、躁动及应激反应的影响。方法:选取我院2022年6月至2023年12月收治的62例拟行腹腔镜手术患儿,采用随机数字表法分为地佐辛组和舒芬太尼组(n=31),分别于术前15 min静脉注射地佐辛0.1 mg·kg^(-1)或舒芬太尼0.2μg·kg^(-1)。比较两组患儿术后不同时间点的疼痛程度,苏醒期躁动发生情况,手术前后采用ELISA法检测肾上腺素(Epinephrine,E)、胰高血糖素(Glucagon,GCG)水平,记录拔管后30 min及术后24 h不良反应发生情况,统计两组患儿家属对麻醉满意度。结果:舒芬太尼组术后4 h、8 h的儿童疼痛行为量表(The face,legs,activity,cry,consolability behavioral tool,FLACC)评分均低于地佐辛组(P<0.05)。术后,舒芬太尼组血清E、GCG水平均低于地佐辛组(P<0.05)。地佐辛组不良反应总发生率低于舒芬太尼组(P<0.05)。结论:地佐辛和舒芬太尼均可安全用于小儿腹腔镜手术,舒芬太尼的术后镇痛效果优于地佐辛,对术后应激反应影响较小,但不良反应发生率高。

Objective:To compare the effects of dezocine and sufentanil on analgesia,agitation,and stress response after pediatric laparoscopic surgery.Methods:A total of 62 children who were admitted to our hospital from June 2022 to December 2023 and planned to undergo laparoscopic surgery were selected.They were randomly divided into two groups using a random number table method:the dexamethasone group and the sufentanil group(n=31).dezosin 0.1 mg·kg^(-1) or sufentanil 0.2μg·kg^(-1) were intravenously injected 15 minutes before surgery,respectively.The degree of pain and the occurrence of restlessness during the recovery period between two groups of pediatric patients at different time points after surgery were compared.Before and after surgery,ELISA was used to detect the levels of epinephrine(E)and glucagon(GCG).The occurrence of adverse reactions 30 minutes after extubation and 24 hours after surgery were recorded,and the satisfaction of the families of the two groups of pediatric patients with anesthesia was calculated.Results:The face,legs,activity,cry,consolability behavioral tool(FLACC)scores of the sufentanil group were lower than those of the dezocine group at 4 hours and 8 hours after surgery(P<0.05).After surgery,serum E and GCG levels in the sufentanil group were lower than those in the dezocine group(P<0.05).The total incidence of adverse reactions in the dezocine group was lower than that in the sufentanil group(P<0.05).Conclusion:Both dezocine and sufentanil are safe for pediatric laparoscopic surgery,and sufentanil can achieve a better postoperative analgesic effect than dexamethasone.It has less influence on postoperative stress response,but a higher incidence of adverse reactions.