中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2014年
6期
808-810
,共3页
胆囊切除术,腹腔镜%镇痛%地佐辛
膽囊切除術,腹腔鏡%鎮痛%地佐辛
담낭절제술,복강경%진통%지좌신
Cholecystectomy,laparoscopic%Analgesia%Dezocine
目的 探讨地佐辛不同剂量不同给药时间用于腹腔镜胆囊切除术后镇痛有效性和安全性.方法 选择ASA Ⅰ～Ⅱ级择期腹腔镜胆囊切除术患者80例,随机单纯法均分成四组,每组均20例.Ⅰ组:麻醉后手术开始前静脉注射地佐辛0.10 mg/kg;Ⅱ组:麻醉后手术开始前静脉注射地佐辛0.15 mg/kg;Ⅲ组:术毕停麻醉药后10 min静脉注射地佐辛0.10 mg/kg;Ⅳ组:术毕停麻醉药后10 min静脉注射地佐辛0.15 rng/kg.比较四组术后1、6、12、24 h时间点的疼痛评分[采用视觉模拟评分法(VAS)]、舒适度评分(BCS)、麻醉后恢复评分(改良Aldrete评分)及不良反应.结果 四组术后lh的VAS:Ⅰ组与Ⅲ组比较差异有统计学意义(t =2.308,P=0.036),Ⅰ组与Ⅳ组差异有统计学意义(t=2.106,P=0.042),Ⅱ组与Ⅲ组比较差异有统计学意义(t =2.711,P=0.014),Ⅱ组与Ⅳ组比较差异有统计学意义(t=2.317,P=0.037);BCS:Ⅰ组与Ⅲ组比较差异有统计学意义(t=2.108,P=0.042),Ⅰ组与Ⅳ组比较差异有统计学意义(t=2.069,P=0.048),Ⅱ组与Ⅲ组比较差异有统计学意义(t=2.353,P=0.033),Ⅱ组与Ⅳ组比较差异有统计学意义(t=2.361,P=0.036);6 h的VAS:Ⅰ组与Ⅲ组比较差异有统计学意义(t=2.084,P=0.045),Ⅱ组与Ⅲ组比较差异有统计学意义(t=2.309,P=0.038),Ⅱ组与Ⅳ组比较差异有统计学意义(t=2.303,P=0.040);BCS:Ⅰ组与Ⅲ组比较差异有统计学意义(=2.294,P=0.041),Ⅱ组与Ⅲ组比较差异有统计学意义(t=2.322,P=0.035),Ⅱ组与Ⅳ组比较差异有统计学意义(t=2.070,P=0.048);12 h的BCS:Ⅱ组与Ⅲ组比较差异有统计学意义(t=2.518,P=0.047);其他各时间点的VAS和BCS评分组间差异均无统计学意义(均P＞0.05).结论 地佐辛0.10 mg/kg和0.15 mg/kg之间剂量可用于术后镇痛,0.15 mg/kg剂量麻醉后手术开始前给药,能有效缓解术后疼痛,提高术后舒适度,不良反应少,值得临床推广.
目的 探討地佐辛不同劑量不同給藥時間用于腹腔鏡膽囊切除術後鎮痛有效性和安全性.方法 選擇ASA Ⅰ～Ⅱ級擇期腹腔鏡膽囊切除術患者80例,隨機單純法均分成四組,每組均20例.Ⅰ組:痳醉後手術開始前靜脈註射地佐辛0.10 mg/kg;Ⅱ組:痳醉後手術開始前靜脈註射地佐辛0.15 mg/kg;Ⅲ組:術畢停痳醉藥後10 min靜脈註射地佐辛0.10 mg/kg;Ⅳ組:術畢停痳醉藥後10 min靜脈註射地佐辛0.15 rng/kg.比較四組術後1、6、12、24 h時間點的疼痛評分[採用視覺模擬評分法(VAS)]、舒適度評分(BCS)、痳醉後恢複評分(改良Aldrete評分)及不良反應.結果 四組術後lh的VAS:Ⅰ組與Ⅲ組比較差異有統計學意義(t =2.308,P=0.036),Ⅰ組與Ⅳ組差異有統計學意義(t=2.106,P=0.042),Ⅱ組與Ⅲ組比較差異有統計學意義(t =2.711,P=0.014),Ⅱ組與Ⅳ組比較差異有統計學意義(t=2.317,P=0.037);BCS:Ⅰ組與Ⅲ組比較差異有統計學意義(t=2.108,P=0.042),Ⅰ組與Ⅳ組比較差異有統計學意義(t=2.069,P=0.048),Ⅱ組與Ⅲ組比較差異有統計學意義(t=2.353,P=0.033),Ⅱ組與Ⅳ組比較差異有統計學意義(t=2.361,P=0.036);6 h的VAS:Ⅰ組與Ⅲ組比較差異有統計學意義(t=2.084,P=0.045),Ⅱ組與Ⅲ組比較差異有統計學意義(t=2.309,P=0.038),Ⅱ組與Ⅳ組比較差異有統計學意義(t=2.303,P=0.040);BCS:Ⅰ組與Ⅲ組比較差異有統計學意義(=2.294,P=0.041),Ⅱ組與Ⅲ組比較差異有統計學意義(t=2.322,P=0.035),Ⅱ組與Ⅳ組比較差異有統計學意義(t=2.070,P=0.048);12 h的BCS:Ⅱ組與Ⅲ組比較差異有統計學意義(t=2.518,P=0.047);其他各時間點的VAS和BCS評分組間差異均無統計學意義(均P＞0.05).結論 地佐辛0.10 mg/kg和0.15 mg/kg之間劑量可用于術後鎮痛,0.15 mg/kg劑量痳醉後手術開始前給藥,能有效緩解術後疼痛,提高術後舒適度,不良反應少,值得臨床推廣.
목적 탐토지좌신불동제량불동급약시간용우복강경담낭절제술후진통유효성화안전성.방법 선택ASA Ⅰ～Ⅱ급택기복강경담낭절제술환자80례,수궤단순법균분성사조,매조균20례.Ⅰ조:마취후수술개시전정맥주사지좌신0.10 mg/kg;Ⅱ조:마취후수술개시전정맥주사지좌신0.15 mg/kg;Ⅲ조:술필정마취약후10 min정맥주사지좌신0.10 mg/kg;Ⅳ조:술필정마취약후10 min정맥주사지좌신0.15 rng/kg.비교사조술후1、6、12、24 h시간점적동통평분[채용시각모의평분법(VAS)]、서괄도평분(BCS)、마취후회복평분(개량Aldrete평분)급불량반응.결과 사조술후lh적VAS:Ⅰ조여Ⅲ조비교차이유통계학의의(t =2.308,P=0.036),Ⅰ조여Ⅳ조차이유통계학의의(t=2.106,P=0.042),Ⅱ조여Ⅲ조비교차이유통계학의의(t =2.711,P=0.014),Ⅱ조여Ⅳ조비교차이유통계학의의(t=2.317,P=0.037);BCS:Ⅰ조여Ⅲ조비교차이유통계학의의(t=2.108,P=0.042),Ⅰ조여Ⅳ조비교차이유통계학의의(t=2.069,P=0.048),Ⅱ조여Ⅲ조비교차이유통계학의의(t=2.353,P=0.033),Ⅱ조여Ⅳ조비교차이유통계학의의(t=2.361,P=0.036);6 h적VAS:Ⅰ조여Ⅲ조비교차이유통계학의의(t=2.084,P=0.045),Ⅱ조여Ⅲ조비교차이유통계학의의(t=2.309,P=0.038),Ⅱ조여Ⅳ조비교차이유통계학의의(t=2.303,P=0.040);BCS:Ⅰ조여Ⅲ조비교차이유통계학의의(=2.294,P=0.041),Ⅱ조여Ⅲ조비교차이유통계학의의(t=2.322,P=0.035),Ⅱ조여Ⅳ조비교차이유통계학의의(t=2.070,P=0.048);12 h적BCS:Ⅱ조여Ⅲ조비교차이유통계학의의(t=2.518,P=0.047);기타각시간점적VAS화BCS평분조간차이균무통계학의의(균P＞0.05).결론 지좌신0.10 mg/kg화0.15 mg/kg지간제량가용우술후진통,0.15 mg/kg제량마취후수술개시전급약,능유효완해술후동통,제고술후서괄도,불량반응소,치득림상추엄.
Objective To investigate the efficacy and safety of different doses of dezocine at different administration time on analgesia after laparoscopic cholecystectomy.Methods 80 patients elected from ASA Ⅰ-Ⅱ grade laparoscopic cholecystectomy were randomly divided into four groups,20 cases in each group.Group Ⅰ was anesthetized by intravenously injected dezocine 0.10mg/kg before the surgery,group Ⅱ was anesthetized by dezocine 0.15mg/kg before the surgery,group Ⅲ was anesthetized by intravenously injected dezocine 0.10mg/kg after stopping anesthetic surgery,and group Ⅳ was anesthetized by intravenously injected dezocine 0.15mg/kg after stopping anesthetic surgery.The postoperative pain scores were observed 1,6,12,24 hours after operation in the four groups by using visual analog scale (VAS),comfort score (BCS),and anesthesia recovery score (modified Aldrete score).Results TheVAS of the four groups 1 hour after surgery:group Ⅰ and group Ⅲ was significantly different(t =2.308,P =0.036),group Ⅰ and group Ⅳ was significantly different (t =2.106,P =0.042),group Ⅱ and group Ⅲ was significantly different (t =2.711,P =0.014),group Ⅱ and group Ⅳ was significantly different (t =2.317,P =0.037).The BCS 1 hour after surgery:group Ⅰ and group Ⅲ was significantly different(t =2.108,P =0.042),group Ⅰ and group Ⅳ was significantly different(t =2.069,P =0.048),group Ⅱ and group Ⅲ was significantly different (t =2.353,P =0.033),group Ⅱ and group Ⅳ was significantly different (t =2.361,P =0.036).The VAS 6 hours after surgery:group Ⅰ and group Ⅲ was significantly different (t =2.084,P =0.045),group Ⅱ and group Ⅲ was significantly different(t =2.309,P =0.038),group Ⅱ and group Ⅳ was significantly different(t =2.303,P =0.040).The BCS 6 hours after surgery:group Ⅰ and group Ⅲ was significantly different (t =2.294,P =0.041),group Ⅱ and group Ⅲ was significantly different(t =2.322,P =0.035),group Ⅱ and group Ⅳ was significantly different (t =2.070,P =0.048).The BCS 12 hours after surgery:group Ⅱ and group Ⅲ was significantly different(t =2.518,P =0.047).VAS and BCS scores at other time points had no significant difference (P ＞ 0.05).Conclusion The analgesic after laparoscopic gallbladder surgery using dezocine 0.10mg/kg-0.15mg/kg,especially 0.15mg/kg administered anesthesia before surgery,can effectively relieve postoperative pain and improve postoperative comfort,reduce postoperative analgesic(pain pump) and has less adverse reactions,which is worthy of promotion.
