地佐辛复合氟比洛芬与舒芬太尼用于痔疮术后静脉自控镇痛的比较.docVIP

地佐辛复合氟比洛芬与舒芬太尼用于痔疮术后静脉自控镇痛的比较 　　摘要：目的 观察地佐辛复合氟比洛芬酯与舒芬太尼用于痔疮术后静脉自控镇痛的效果及安全性比较。方法 选择肛肠科择期行痔疮手术的成年患者60例，ASAⅠ～Ⅱ级，随机均分为地佐辛复合氟比洛芬酯组（DF组）和舒芬太尼组（S组），两组患者均在单次腰麻下行手术，绝对麻醉平面固定到胸10水平。两组患者术毕行静脉自控镇痛（PCIA），DF组镇痛泵配方为地佐辛30mg+氟比洛芬酯150mg，S组为舒芬太尼0.001mg/（d?kg），两组均加生理盐水配至100ml。术后记录2、4、8、12、24、48h各时间点患者的VAS评分、Ramsay镇静评分和不良反应的发生情况，有效按压次数及补救性镇痛药物的量。结果 两组患者术后VAS评分、Ramsay镇静评分和有效按压次数在术后48h内差异均无统计学意义，两组均未行补救治疗。DF组不良反应明显少于S组（P0.05）。结论 与舒芬太尼比较，地佐辛复合氟比洛芬酯能更安全有效的用于痔疮患者术后镇痛。 　　关键词：地佐辛；氟比洛芬酯；舒芬太尼；静脉自控镇痛；痔疮手术 　　Abstract：Objective To investigate the effects of dezocine combined with flurbiprofen and sufentanil for patients control intravenous analgesia（PCIA）after Hemorrhoids surgeries.Methods Sixty patients scheduled for selective Hemorrhoids surgeries were randomly divided into dezocine combined with flurbiprofen group（group DF）and sufentanil group（group S），each group of 30 cases，two groups of patients were in single spinal anesthesia surgery，absolutely anesthesia plane fixed to the level 10 of the chest，were given patient-controlled intravenous analgesia（PCIA）after Hemorrhoids surgery.Patients in group DF were given dezocine 30 mg+flurbiprofen 150 mg+0.9%NaCl=100ml；Patients in group S were given sufentanil 0.001mg/（d?kg）.Visual analogue scores（VAS），Ramsay score，the effective number of PCA，the side effects（nausea，vomiting，dizziness，respiratory depression and so on）and the amount of salvage analgesic drugs were recorded at 2，4，8，12，24，48 h postoperatively.Results The postoperative VAS score，Ramsay score and the number of effective press were no significant differences between two groups，the two groups were not treated by the treatment.The adverse reactions of the DF group were significantly less than that of the S group（P0.05）.Conclusion Compared with sufentanil，dezocine combined with flurbiprofen can be more safe and effective for postoperative analgesia in patients with Hemorrhoids surgery. 　　Key words：Dezocine；Flurbiprofen；Sufentanil；Patients control intravenous analgesia（PCIA）；Hemorrhoids