地佐辛与舒芬太尼应用于术后静脉镇痛的临床效果比较.docVIP

地佐辛与舒芬太尼应用于术后静脉镇痛的临床效果比较 郑艳 朱志华 刘岩 （吉林大学中日联谊医院麻醉科，吉林 长春 130031） 【摘要】目的 观察地佐辛、舒芬太尼用于乳腺癌根治手术术后静脉镇痛的效果及不良反应。方法 将60例ASAⅠ-Ⅱ择期行乳腺癌手术患者，随机分为地佐辛组（D组）、舒芬太尼（S组）两组，每组30例，术后行PCIA。配方分别是D组：地佐辛0.8mg/kg+盐酸昂丹司琼0.2mg/kg加生理盐水稀释至100ml,S组：舒芬太尼2.5ug/kg+盐酸昂丹司琼0.2mg/kg加生理盐水稀释至100ml。观察两组患者术后4、8、12、24、48h视觉模拟评分（VAS）、镇静程度评分（Ramesy））ntravenous Analgesia with Dezocine and sufentanil Zheng Yan,Zhu Zhi-hua,Liu Yan (Department of Anesthesiology,China-Japan United Hospital of Jilin University, Jilin ,changchun 130031 ,China) 【Abstract】analgesia effects and side effects of PCIA with dezocine and sufentanil in radical surgery for breast cancer.Methods 60 patients with ASAⅠ-Ⅱ that were scheduled for radical surgery for breast cancer under general anesthesia ,randomly assigned into dezocine group(Group D,n＝30),sufentanil group(Group S,n＝30).PCIA gradients used for Group D and Group S was dezocine 0.8mg/kg+ Ondansetron HCL0.2mg/kg; sufentanil 2.5ug/kg+ Ondansetron HCL0.2mg/kg which were diluted to be 100 ml by adding saline.To observe the patient’s VAS,Ramesy scores and pressing times of PCA equipment,side effects at the times at 4,8,12,24,48h after operation. Results There was no significant difference in the effects of the two kinds of PCIA. But group D showed better outcomes regarding to Ranesy score and patient’s satisfactory degree than group S. Group D also give less side effects. Conclusion Dezocine can take a satisfactory effect and fewer side effecs in PCIA in patients underwent radical surgery for breast cancer, and it’s worth for clinical application. 【Key words】 Dezocine; Sufentanil; Postoperative analgesia 阿片类药物已经被广泛的作为术后镇痛不可缺少的药物应用于临床，其镇痛效应是大家公认的，但是其呼吸抑制、恶心 、呕吐、尿潴留等副作用也备受大家关注，因此，能否找到一种镇痛药物，既有良好的镇痛效果，又尽量减少其副用就成为我们追求的目标。本研究旨在通过随机对照设计比较当今常用的镇痛药物地佐辛与舒芬太尼对乳腺癌根治手术后的镇痛效果及不良反应，为临床提供依据。 资料与方法 1.1 临床资料 选择60例ASAⅠ-Ⅱ择期行乳腺癌手术患者，年龄25-60岁，体重45-75公斤。随机分成二组：地佐辛组（D组,n＝30）、舒芬太尼（S组n＝30）。患者知情同意，排除吸毒史及既往麻醉镇痛药物使用史。 1.2 麻醉方法 患者术前肌肉注射盐酸戊乙奎醚（长托宁）1mg。入室后建立静脉通路，常规监测血压、脉搏氧饱和度、心电图，两组患者均用静脉注射咪唑安定0.05mg/kg，芬太尼2ug/kg，丙泊