中国医药
中國醫藥
중국의약
CHINA MEDICINE
2011年
6期
698-699
,共2页
曾兆东%程明华%林树勇%庄少惠
曾兆東%程明華%林樹勇%莊少惠
증조동%정명화%림수용%장소혜
地佐辛%镇痛%曲马多
地佐辛%鎮痛%麯馬多
지좌신%진통%곡마다
Dezocine%Analgesia%Tramadol
目的 比较地佐辛与曲马多单次静脉给药用于腹腔镜胆囊切除术后患者患者早期镇痛的效果及不良反应.方法 选择择期行腹腔镜胆囊切除术患者40例,美国麻醉师协会Ⅰ～Ⅱ,年龄18～65岁,完全随机分为地佐辛组和曲马多组,各20例,均采用气管插管全身静脉麻醉.术中靶控输注异丙酚、瑞芬太尼,间断给予顺式阿曲库铵维持麻醉.地佐辛组关腹前30 min分别静脉注射地佐辛0.1 mg/kg、曲马多组给予曲马多2 mg/kg.记录2组术前(T0)、给药时(T1)、拔管时(T2)、拔管后5 min(T3)、拔管后10 min(T4)、拔管后30 min(T5)、拔管后1 h(T6)患者的HR、SBP、DBP和动脉血氧分压(SpO2),并观测苏醒时间、拔管时间以及T3、T4、T5、T6的视觉模拟评分(VAS),观察拔管后患者的不良反应情况.用警觉/镇静评分评估患者全麻后意识恢复程度.结果 地佐辛组T2、T3时间点心率分别为(105±11)、(96±10)次/min,明显低于曲马多组[分别为(93±6)、(87±6)次/min,P<0.05],SpO2在T2、T3、T4时间点差异无统计学意义,T4时间点地佐辛组VAS评分明显高于曲马多组[(2.06±0.85)分比(2.69±0.93)分,P<0.05].曲马多组呼吸抑制1例,恶心呕吐3例,躁动2例;地佐辛组呼吸抑制1例,躁动1例,头晕1例.2组不良反应发生情况差异无统计学意义.结论 地佐辛在拔管早期对抑制拔管反应的作用和镇痛比曲马多好,不良反应较少.
目的 比較地佐辛與麯馬多單次靜脈給藥用于腹腔鏡膽囊切除術後患者患者早期鎮痛的效果及不良反應.方法 選擇擇期行腹腔鏡膽囊切除術患者40例,美國痳醉師協會Ⅰ～Ⅱ,年齡18～65歲,完全隨機分為地佐辛組和麯馬多組,各20例,均採用氣管插管全身靜脈痳醉.術中靶控輸註異丙酚、瑞芬太尼,間斷給予順式阿麯庫銨維持痳醉.地佐辛組關腹前30 min分彆靜脈註射地佐辛0.1 mg/kg、麯馬多組給予麯馬多2 mg/kg.記錄2組術前(T0)、給藥時(T1)、拔管時(T2)、拔管後5 min(T3)、拔管後10 min(T4)、拔管後30 min(T5)、拔管後1 h(T6)患者的HR、SBP、DBP和動脈血氧分壓(SpO2),併觀測囌醒時間、拔管時間以及T3、T4、T5、T6的視覺模擬評分(VAS),觀察拔管後患者的不良反應情況.用警覺/鎮靜評分評估患者全痳後意識恢複程度.結果 地佐辛組T2、T3時間點心率分彆為(105±11)、(96±10)次/min,明顯低于麯馬多組[分彆為(93±6)、(87±6)次/min,P<0.05],SpO2在T2、T3、T4時間點差異無統計學意義,T4時間點地佐辛組VAS評分明顯高于麯馬多組[(2.06±0.85)分比(2.69±0.93)分,P<0.05].麯馬多組呼吸抑製1例,噁心嘔吐3例,躁動2例;地佐辛組呼吸抑製1例,躁動1例,頭暈1例.2組不良反應髮生情況差異無統計學意義.結論 地佐辛在拔管早期對抑製拔管反應的作用和鎮痛比麯馬多好,不良反應較少.
목적 비교지좌신여곡마다단차정맥급약용우복강경담낭절제술후환자환자조기진통적효과급불량반응.방법 선택택기행복강경담낭절제술환자40례,미국마취사협회Ⅰ～Ⅱ,년령18～65세,완전수궤분위지좌신조화곡마다조,각20례,균채용기관삽관전신정맥마취.술중파공수주이병분、서분태니,간단급여순식아곡고안유지마취.지좌신조관복전30 min분별정맥주사지좌신0.1 mg/kg、곡마다조급여곡마다2 mg/kg.기록2조술전(T0)、급약시(T1)、발관시(T2)、발관후5 min(T3)、발관후10 min(T4)、발관후30 min(T5)、발관후1 h(T6)환자적HR、SBP、DBP화동맥혈양분압(SpO2),병관측소성시간、발관시간이급T3、T4、T5、T6적시각모의평분(VAS),관찰발관후환자적불량반응정황.용경각/진정평분평고환자전마후의식회복정도.결과 지좌신조T2、T3시간점심솔분별위(105±11)、(96±10)차/min,명현저우곡마다조[분별위(93±6)、(87±6)차/min,P<0.05],SpO2재T2、T3、T4시간점차이무통계학의의,T4시간점지좌신조VAS평분명현고우곡마다조[(2.06±0.85)분비(2.69±0.93)분,P<0.05].곡마다조호흡억제1례,악심구토3례,조동2례;지좌신조호흡억제1례,조동1례,두훈1례.2조불량반응발생정황차이무통계학의의.결론 지좌신재발관조기대억제발관반응적작용화진통비곡마다호,불량반응교소.
Objective To study the effect of dezocine versus tramadol for postoperative analgesia and side effects after laparoscopic cholecystectomy. Methods Forty patients with postoperative analgesia, American Society of Anesthesiologists I - II class, were randomly divided into two groups. Target controlled infusion of propofol and remifentanly was used to both groups. Both groups were given intermittent cisatracurium. The single intravenous injections of dezocine(0.1 mg/kg)and tramdol(2 mg/kg) were given before 30 min of operation closure. The analgesic efficacy and side effects was assessed by verbal and visual scales at regular intervals after administration. Hemo-dynamic parameters and SpO2 were recorded, before operation, after administration, extubation time, 5, 10, 30, 60 min after extubation. The visual analogue scale(VAS) pain score and OAA/S score of 5, 10, 30, 60 min after extubation were conducted. Adverse reactions with nausea and vomiting and dysthesia after extubation were obtained. Results There was statistical significance of hemodynamic parameters of extubation(P<0.05). Tramadol group (Group T) has the highest incidence of nausea and vomiting. Dezocine group (Group D)has the highest VAS score after recovery (P<0.05). There were no significant changes in respiratory parameters. Conclusion A single 0. 1 mg intravenous injection of dezocine is safe and effective for postoperative pain after laparoscopic cholecystectomy.
