国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2013年
20期
3129-3131
,共3页
赖有平%邢首平%黎志伟%梁增升
賴有平%邢首平%黎誌偉%樑增升
뢰유평%형수평%려지위%량증승
地佐辛%妇科腹腔镜手术%超前镇痛
地佐辛%婦科腹腔鏡手術%超前鎮痛
지좌신%부과복강경수술%초전진통
Dezocine%Gynecological laparoscopic surgery%Preemptive analgesia
目的 探讨术前静注不同剂量地佐辛对妇科腹腔镜手术后疼痛的影响.方法 120例全身麻醉下行妇科腹腔镜手术患者,ASA Ⅰ～Ⅱ级,按数字表法随机分为A、B、C三组,每组40例.A组手术切皮前静注生理盐水5 ml,B组切皮前静注地佐辛0.1 mg/kg(稀释成5 ml),C组切皮前静注地佐辛0.2 mg/kg(稀释成5 ml).麻醉诱导诱导用药为咪唑安定、丙泊酚、顺阿曲库胺、芬太尼.麻醉维持泵注丙泊酚、瑞芬太尼,吸入七氟烷,间断注入顺阿曲库胺.分别于出复苏室后2h(T1)、4 h(T2)、8 h(T3)、24 h(T4)对患者行VAS、BCS评分,当患者VAS为8～ 10,BCS为0,给予曲马多100 mg im.记录各组曲马多使用时间、例数、次数.观察术后24 h内各组恶心呕吐、头昏嗜睡、呼吸抑制、皮肤瘙痒等不良反应.结果 C组各时点VAS评分低于A、B组,B组低于A组(P＜0.05).A组术后曲马多使用量[(121.5±2.3)mg]大于B、C组(P＜0.05),B组[(51.5±2.1)mg]大于C组[(18.7±1.8)mg] (P＜0.05).术后各时点BCS评分C组最高,B组次之,A组最低(P＜0.05).三组恶心呕吐的发生率比较无统计学差异(7.5％ vs.7.5％ vs.10％,P＞0.05).B、C组躁动明显少于A组(2.5％ vs.2.5％ vs.10.0％,P＜0.05).结论 地佐辛0.2 mg/kg超前镇痛可使妇科腹腔镜手术患者术后疼痛减轻,满意度提高.
目的 探討術前靜註不同劑量地佐辛對婦科腹腔鏡手術後疼痛的影響.方法 120例全身痳醉下行婦科腹腔鏡手術患者,ASA Ⅰ～Ⅱ級,按數字錶法隨機分為A、B、C三組,每組40例.A組手術切皮前靜註生理鹽水5 ml,B組切皮前靜註地佐辛0.1 mg/kg(稀釋成5 ml),C組切皮前靜註地佐辛0.2 mg/kg(稀釋成5 ml).痳醉誘導誘導用藥為咪唑安定、丙泊酚、順阿麯庫胺、芬太尼.痳醉維持泵註丙泊酚、瑞芬太尼,吸入七氟烷,間斷註入順阿麯庫胺.分彆于齣複囌室後2h(T1)、4 h(T2)、8 h(T3)、24 h(T4)對患者行VAS、BCS評分,噹患者VAS為8～ 10,BCS為0,給予麯馬多100 mg im.記錄各組麯馬多使用時間、例數、次數.觀察術後24 h內各組噁心嘔吐、頭昏嗜睡、呼吸抑製、皮膚瘙癢等不良反應.結果 C組各時點VAS評分低于A、B組,B組低于A組(P＜0.05).A組術後麯馬多使用量[(121.5±2.3)mg]大于B、C組(P＜0.05),B組[(51.5±2.1)mg]大于C組[(18.7±1.8)mg] (P＜0.05).術後各時點BCS評分C組最高,B組次之,A組最低(P＜0.05).三組噁心嘔吐的髮生率比較無統計學差異(7.5％ vs.7.5％ vs.10％,P＞0.05).B、C組躁動明顯少于A組(2.5％ vs.2.5％ vs.10.0％,P＜0.05).結論 地佐辛0.2 mg/kg超前鎮痛可使婦科腹腔鏡手術患者術後疼痛減輕,滿意度提高.
목적 탐토술전정주불동제량지좌신대부과복강경수술후동통적영향.방법 120례전신마취하행부과복강경수술환자,ASA Ⅰ～Ⅱ급,안수자표법수궤분위A、B、C삼조,매조40례.A조수술절피전정주생리염수5 ml,B조절피전정주지좌신0.1 mg/kg(희석성5 ml),C조절피전정주지좌신0.2 mg/kg(희석성5 ml).마취유도유도용약위미서안정、병박분、순아곡고알、분태니.마취유지빙주병박분、서분태니,흡입칠불완,간단주입순아곡고알.분별우출복소실후2h(T1)、4 h(T2)、8 h(T3)、24 h(T4)대환자행VAS、BCS평분,당환자VAS위8～ 10,BCS위0,급여곡마다100 mg im.기록각조곡마다사용시간、례수、차수.관찰술후24 h내각조악심구토、두혼기수、호흡억제、피부소양등불량반응.결과 C조각시점VAS평분저우A、B조,B조저우A조(P＜0.05).A조술후곡마다사용량[(121.5±2.3)mg]대우B、C조(P＜0.05),B조[(51.5±2.1)mg]대우C조[(18.7±1.8)mg] (P＜0.05).술후각시점BCS평분C조최고,B조차지,A조최저(P＜0.05).삼조악심구토적발생솔비교무통계학차이(7.5％ vs.7.5％ vs.10％,P＞0.05).B、C조조동명현소우A조(2.5％ vs.2.5％ vs.10.0％,P＜0.05).결론 지좌신0.2 mg/kg초전진통가사부과복강경수술환자술후동통감경,만의도제고.
Objective To study the effect of preemptive analgesia intravenous injection with different doses of dezocine on postoperative pain after gynecological laparoscopic operation.Methods 120 female adult patients (the ASA Ⅰ-Ⅱ) who underwent the gynecological laparoscopic surgery were randomly divided into three groups.Patients in the group A were given physiological saline 5 ml before operation.Patients in the group B were given dezocine 0.1 mg/kg (diluted to 5 ml) before operation.Patients in the group C were given dezocine 0.2 mg/kg (diluted to 5 ml) before operation.Anesthesia induction and anesthesia contiue were the same.After returning to the anesthesia recovery room,the pain of incision was assessed by VAS and BCS scores at 2 h(T1),4 h(T2),8 h(T3) and 24 h(T4).When the VAS scores reached 8-10 and the BCS score was 0,patients were given 100 mg tramadol intramuscular injection.Records of the tramadol use time,number of cases,the intervals of tramadol.Results The VAS and BCS scores of patients at 2 h(T1),4h(T2),8 h(T3) and 24 h(T4) after reached the anesthesia recovery room,the experimental group was better than control group (P＜0.05).Postoperative tramadol group A greater than group B (P＜0.05),group B greater than group C (P＜0.05).The incidence of adverse reactions of the three groups had no statistical difference (P＞0.05).Conclusion Dezocine preemptive analgesia with 0.2 mg/kg can relieve pain in patients after gynecological laparoscopic operation,and increase satisfaction.
