CAJ | 학술논문

目的：观察和比较地佐辛、盐酸曲马朵和酒石酸布托啡诺用于剖宫产术后静脉自控镇痛（PCIA）的镇痛效果。方法将150例剖宫产产妇随机分为地佐辛组（A组）、盐酸曲马朵组（B组）、酒石酸布托啡诺组（C组），每组50例。三组产妇均在腰硬联合麻醉下施术，术中麻醉效果满意，术毕立即接静脉输注镇痛泵，药物配方为A组：地佐辛50 mg＋盐酸托烷司琼5 mg＋0.9%氯化钠注射液100 ml；B组：盐酸曲马朵1000 mg＋盐酸托烷司琼5 mg＋0.9%氯化钠注射液共100 ml；C组：酒石酸布托啡诺10 mg＋盐酸托烷司琼5 mg＋0.9%氯化钠注射液共100 ml。观察各组术后4 h、12 h、24 h、36 h、48 h各时间点的静息疼痛和动态疼痛，并采用视觉疼痛模拟评分法（VAS）进行评分，记录各种不良反应的发生。结果静息疼痛VAS评分：4 h、12 h A组低于B、C 组，差异有统计学意义（P＜0.05），B、C组各时间点组间差异无统计学意（P＞0.05）。动态疼痛VAS评分：4 h、12 h、24 h A组低于B、C 组，差异有统计学意义（P＜0.05），B、C 组各时间点组间差异无统计学意义（P＞0.05）。不良反应（恶心呕吐、头晕头痛、嗜睡）C组的发生率高于A组，差异有统计学意义（P＜0.05）。结论三种药物可安全用于剖宫产术后静脉镇痛，效果可靠，其中地佐辛联合盐酸托烷司琼镇痛效果良好，且不良反应相对较少。
목적：관찰화비교지좌신、염산곡마타화주석산포탁배낙용우부궁산술후정맥자공진통（PCIA）적진통효과。방법장150례부궁산산부수궤분위지좌신조（A조）、염산곡마타조（B조）、주석산포탁배낙조（C조），매조50례。삼조산부균재요경연합마취하시술，술중마취효과만의，술필립즉접정맥수주진통빙，약물배방위A조：지좌신50 mg＋염산탁완사경5 mg＋0.9%록화납주사액100 ml；B조：염산곡마타1000 mg＋염산탁완사경5 mg＋0.9%록화납주사액공100 ml；C조：주석산포탁배낙10 mg＋염산탁완사경5 mg＋0.9%록화납주사액공100 ml。관찰각조술후4 h、12 h、24 h、36 h、48 h각시간점적정식동통화동태동통，병채용시각동통모의평분법（VAS）진행평분，기록각충불량반응적발생。결과정식동통VAS평분：4 h、12 h A조저우B、C 조，차이유통계학의의（P＜0.05），B、C조각시간점조간차이무통계학의（P＞0.05）。동태동통VAS평분：4 h、12 h、24 h A조저우B、C 조，차이유통계학의의（P＜0.05），B、C 조각시간점조간차이무통계학의의（P＞0.05）。불량반응（악심구토、두훈두통、기수）C조적발생솔고우A조，차이유통계학의의（P＜0.05）。결론삼충약물가안전용우부궁산술후정맥진통，효과가고，기중지좌신연합염산탁완사경진통효과량호，차불량반응상대교소。
Objective To observe and compare the analgesic effect of dezocine, tramadol hydrochloride and butorphanol tartrate for intravenous analgesia after cesarean section. Methods 150 cases of parturients after cesarean section were randomly divided into dezocine group(A), tramadol hydrochloride group(B)and butorphanol tartrate group (C)(n=50 in each group). All cases were under combined spinal and epidural anesthesia and were given intravenous analgesia after surgery immediately. At the end of operation, the parturients were given intravenous analgesia with. dezocine 50 mg, tropisetron hydrochloride 5 mg and 0.9%sodium chloride injection totaling 100 ml in group A; tramadol hydrochloride 1000 mg, tropisetron hydrochloride 5 mg and 0.9% sodium chloride injection totaling 100 ml in group B and butorphanol tartrate 10 mg, tropisetron hydrochloride 5 mg and 0.9%sodium chloride injection totaling 100 ml in group C. To observe resting pain, dynamic pain and conduct the Visual Analogue pain Score (VAS) scoring at postoperative 4, 12, 24, 36, 48 h and record various adverse reactions. Results The resting pain VAS scores at 4, 12 h in the group A were lower than those in the group B and C with statistical difference (P<0.05). There is no statistical difference (P>0.05) at each time point between the group B and group C. The dynamic pain VAS scores at 4, 12, 24 h in the group A were lower than those in the group B and C with statistical difference (P<0.05). There is no statistical difference (P>0.05) at each time point between the group B and C.The incidence rate of nausea, vomiting, dizziness, headache, and drowsiness in the group C was higher than that in the group A, and the difference was statistically significant (P<0.05). Conclusion The three kinds of analgesics for analgesia after cesarean section were achieved satisfactory results, and dezocine tropisetron hydrochloride combination analgesic effect is good, and relatively few adverse reactions.