中国临床医学
中國臨床醫學
중국림상의학
CLINICAL MEDICAL JOURNAL OF CHINA
2014年
6期
668-670
,共3页
地佐辛%超前镇痛%锁骨下臂丛神经阻滞
地佐辛%超前鎮痛%鎖骨下臂叢神經阻滯
지좌신%초전진통%쇄골하비총신경조체
Dezocine%Preemptive analgesia%Infraclavicular brachial plexus block
目的：观察地佐辛超前镇痛用于臂丛神经阻滞的效果及对术后疼痛的影响。方法：将美国麻醉医师协会（ASA）分级Ⅰ～Ⅱ级、行锁骨下臂丛神经阻滞的60例手术患者随机分为3组，每组20例。A 组将地佐辛5 mg 与局部麻醉药（0．375％罗哌卡因20 mL＋1％利多卡因15 mL＋1∶20万肾上腺素1 mL ）混合用于臂丛神经阻滞。B 组于术前15 min 静脉注射地佐辛5 mg，联合局部麻醉药（同 A 组）；C 组仅行锁骨下臂丛神经阻滞，局部麻醉药同 A 组。记录麻醉起效时间，手术时间，麻醉后1 h 及术后4、8、12、24、36、48 h 的疼痛视觉模拟评分（VAS），术后镇痛持续时间（术毕至术后 VAS＞3分的时间），不良反应。结果：A 组麻醉起效时间低于 B、C 组（P ＜0．05）。A、B 组术后8 h 时的 VAS 明显低于 C 组（P ＜0．05）；A 组术后12、24 h 时的 VAS 明显低于 B、C 组（P ＜0．05）；3组麻醉后1 h 及术后4、36、48 h 时的 VAS 差异无统计学意义（P ＞0．05）。术后镇痛持续时间为 A 组＞B 组＞C 组，差异有统计学意义（P ＜0．05）；A 组和 B 组不良反应发生率差异无统计学意义（P ＞0．05）。结论：地佐辛超前镇痛效果确切，能够延长术后镇痛时间，且不良反应少。
目的：觀察地佐辛超前鎮痛用于臂叢神經阻滯的效果及對術後疼痛的影響。方法：將美國痳醉醫師協會（ASA）分級Ⅰ～Ⅱ級、行鎖骨下臂叢神經阻滯的60例手術患者隨機分為3組，每組20例。A 組將地佐辛5 mg 與跼部痳醉藥（0．375％囉哌卡因20 mL＋1％利多卡因15 mL＋1∶20萬腎上腺素1 mL ）混閤用于臂叢神經阻滯。B 組于術前15 min 靜脈註射地佐辛5 mg，聯閤跼部痳醉藥（同 A 組）；C 組僅行鎖骨下臂叢神經阻滯，跼部痳醉藥同 A 組。記錄痳醉起效時間，手術時間，痳醉後1 h 及術後4、8、12、24、36、48 h 的疼痛視覺模擬評分（VAS），術後鎮痛持續時間（術畢至術後 VAS＞3分的時間），不良反應。結果：A 組痳醉起效時間低于 B、C 組（P ＜0．05）。A、B 組術後8 h 時的 VAS 明顯低于 C 組（P ＜0．05）；A 組術後12、24 h 時的 VAS 明顯低于 B、C 組（P ＜0．05）；3組痳醉後1 h 及術後4、36、48 h 時的 VAS 差異無統計學意義（P ＞0．05）。術後鎮痛持續時間為 A 組＞B 組＞C 組，差異有統計學意義（P ＜0．05）；A 組和 B 組不良反應髮生率差異無統計學意義（P ＞0．05）。結論：地佐辛超前鎮痛效果確切，能夠延長術後鎮痛時間，且不良反應少。
목적：관찰지좌신초전진통용우비총신경조체적효과급대술후동통적영향。방법：장미국마취의사협회（ASA）분급Ⅰ～Ⅱ급、행쇄골하비총신경조체적60례수술환자수궤분위3조，매조20례。A 조장지좌신5 mg 여국부마취약（0．375％라고잡인20 mL＋1％리다잡인15 mL＋1∶20만신상선소1 mL ）혼합용우비총신경조체。B 조우술전15 min 정맥주사지좌신5 mg，연합국부마취약（동 A 조）；C 조부행쇄골하비총신경조체，국부마취약동 A 조。기록마취기효시간，수술시간，마취후1 h 급술후4、8、12、24、36、48 h 적동통시각모의평분（VAS），술후진통지속시간（술필지술후 VAS＞3분적시간），불량반응。결과：A 조마취기효시간저우 B、C 조（P ＜0．05）。A、B 조술후8 h 시적 VAS 명현저우 C 조（P ＜0．05）；A 조술후12、24 h 시적 VAS 명현저우 B、C 조（P ＜0．05）；3조마취후1 h 급술후4、36、48 h 시적 VAS 차이무통계학의의（P ＞0．05）。술후진통지속시간위 A 조＞B 조＞C 조，차이유통계학의의（P ＜0．05）；A 조화 B 조불량반응발생솔차이무통계학의의（P ＞0．05）。결론：지좌신초전진통효과학절，능구연장술후진통시간，차불량반응소。
Objective:To observe the effect of dezocine preemptive analgesia on infraclavicular brachial plexus block and the im-pact of it on postoperative analgesia.Methods:Sixty patients,who were classified by American Society of Anesthesiologists (ASA)criteria as classⅠ-Ⅱ and underwent infraclavicular brachial plexus block,were divided randomly into three groups, with 20 cases in each group.In Group A,5 mg dezocine was combined with local anesthetics(20 mL 0.375 % ropivacaine,15 mL 1% lidocaine and 1mL 1∶200 000 epinephrine)for infraclavicular brachial plexus block;in Group B,5mg dezocine was in-travenously injected 15 minutes before the operation and then the same local anesthetics were used;in Group C,infraclavicular brachial plexus block was performed only with the same local anesthetics.The onset time of anesthesia and the operation time, the visual analogue scale (VAS)at 1 h after anesthesia and 8,12,24,36,48 h after operation and the postoperative analgesia time(the time from the end point of operation to the time point when VAS>3),as well as the side effects were recorded.Re-sults:The onset time of anesthesia in Group A were shorter than that in Group B and C(P <0.05).The VAS at 8 h after operation in Group A and B were significantly lower than that in Group C(P <0.05).The VAS at postoperative 12 and 24 h in Group A were significantly lower than those in Group B and C.There was no statistically significant difference in VAS score at 1 h after anesthesia and at 4,36,48 h after operation among the three groups(P >0.05).The analgesia duration was gradually decreased in Group A ,B and C(P <0.05).There was no statistically significant difference between Group A and B in the in-cidence of side effects.Conclusions:The dezocine preemptive analgesia has exact effect.It could prolong the duration of posto-perative analgesia and has few side effects.
