地佐辛与帕瑞昔布钠防治瑞芬太尼麻醉患者术后痛觉过敏效果的临床分析-临床医学专业论文.docx

II II Abstract Objective: To evaluate the preventive effects of dezocine and parecoxibprevent postoperative pain in patients after reminfentanil-based anesthesia. Methods: Ninety ASA Ⅰ or Ⅱ patients，aged 45-55，weighing 45-65 kg，undergoing laparoscopic hysterectomy，were randomly divided into 3 groups(n=30 each): fentanyl group(group A), dezocine group(group B) and parecoxib group(group C). Anesthesia was induced with midazolam,propofol,remifentanil and cisatracurium. The patients were mechanically ventilated after tracheal intubation. Anesthesia was maintained with target-controlled infusion of remifentanil (target effect-site concentration 4μg/L),intravenous infusion of propofol 4-6 mg·kg-1·h-1 and atracurium0.5mg·kg-1·h-1. Group B received intravenous injection of dezocine 0.2 mg/kg, group C received intravenous injection of parecoxib 40 mg at 20 min before the end of surgery，group A received intravenous injection of fentanyl 1μg/kg at 10 min before the end of surgery. The recovery time and extubation time were recorded. Visual analog scale(VAS), Bruggrmann comfort scale(BCS) and sedation and agitation scale(SAS) at immediately,1 h after recovery from anesthesia(T0，1),and the incidence of nausea and vomiting and shivering and dysphoria after extubation were recorded. Result: Compared with group A,VAS score was decreased and BCS score was increased and SAS score was decreased at T0-1 in group B, VAS score was increased and BCS score was decreased and SAS score was increased at T0-1 in group C(P＜0.05). Compared with group A, the incidence of nausea and vomiting was increased in group B, shivering and dysphoria was increased in group C(P＜0.05). Conclusion: Intravenous injection of dezocine 0.2 mg/kg at 20 min before the end of surgery can reduce postoperative pain with little side effects in patients after reminfentanil-based anesthesia. Key words: Hyperalgesia；General anesthesia；Postoperative complications；Dezocine；Parecoxib； Remifentanil PAGE PAGE IV 目 录 摘要I