| 陈国栋,张超.地佐辛复合舒芬太尼对脊柱手术后静脉镇痛效果的影响[J].浙江中西医结合杂志,2017,27(5): |
| 地佐辛复合舒芬太尼对脊柱手术后静脉镇痛效果的影响 |
| Application of patient controlled intravenous analgesia of dezocine combined with sufentanil in the postoperative analgesia of spine surgery |
| 投稿时间：2016-08-30 修订日期：2017-03-19 |
| DOI： |
| 中文关键词: 地佐辛 脊柱手术 舒芬太尼 术后镇痛 |
| 英文关键词:Dezocine Spine surgery Sufentanil Postoperative analgesia |
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| 中文摘要: |
| 目的 观察地佐辛复合舒芬太尼对脊柱手术后镇痛效果的影响。方法：选择ASA I-Ⅱ级 需要行脊柱手术病例84例,随机数字表法分成四组,术后均采用自控静脉镇痛(PCIA)。A组 地佐辛 0.1mg/kg +舒芬太尼 1.5ug/kg,B组 舒芬太尼2ug/kg,C组地佐辛 0.4mg/kg,D组地佐辛 0.3mg/kg+舒芬太尼1ug/kg。每组均加用托烷司琼8mg稀释到生理盐水100ml,首次剂量1ml,维持剂量2.5ml/h,PCA 1.5ml/次,锁定时间15min。记录患者术后1h、4h、8h、12h、24h、36h和48h的静息和运动(90度翻身运动)时的VAS疼痛评分和Ramsay镇静评分,观察嗜睡、恶心呕吐、皮肤瘙痒和呼吸抑制等不良反应,及术前和术后48小时认知功能评价比较。结果：四组患者术后不同时点翻身运动时VAS评分及术前和术后的认知功能评价比较无统计学意义,但C组与D组在术后1h-8h安静时VAS评分明显高于B组,A组与B组比较无统计学意义, B组的不良反应最多。结论：地佐辛和舒芬太尼适当的配伍用于脊柱手术可获得满意的效果,镇痛效果理想,不良反应少。 |
| 英文摘要: |
| Objective To investigate the analgesic effect of dezocine combined with sufentanil in patients undergoing spinal surgery. Methods Eighty-four patients scheduled for selective spine operation were randomly divided into group dezocine 0.1mg/kg combined with sufentanil 1.5 u g/kg (group A), sufentanil 2 ug/kg (group B) and dezocine 0.4mg/kg (group C) and dezocine 0.3mg/kg combined with sufentanil 1.0 u g/kg (group D). Tropisetron 8mg was also added identically in all groups．Total PCIA volume was 100 saline with loading volume 1 ml,background volume 2.5 ml／h,bolus dose 1.5 ml,and lockout time was set 15 min．The Visual Analogue Score (VAS) of both silence And 90° turn over situation,Ramsay sedation scale were recorded 1h,4h,8h,12h,24h,36h and 48h after surgery．Adverse effects such as drowsiness, nausea, vomiting, skin itching and respiratory depression were observed. And then cognitive function before and after operation and 48 hours after operation were evaluated. Results There was no significant difference in VAS under 90°turn over situation and evaluation of cognitive function before and after operation .But the VAS in silence of group C and group D were higher than group B at 1h-8h (P <0.05). Meanwhile there was no significant difference between the group A and the group B. The adverse reactions in the B group were the most. Conclusion An appropriate combination of Dezocine and sufentanil for spine surgery may obtain satisfactory effect, analgesic effect and less adverse reactions. |
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