Effect of Dezocine Combined with Tramadol in Intravenous Patient-controlled Analgesia for Lung Cancer Patients after Thoracotomy
-
摘要:目的
探讨地佐辛联合盐酸曲马多用于肺癌患者开胸术后自控镇痛的安全性及效果。
方法选择肺癌开胸手术后行术后静脉自控镇痛患者80例，随机分为两组：地佐辛联合盐酸曲马多组（观察组）40例：术后镇痛给予地佐辛25 mg+盐酸曲马多1 g+托烷司琼10 mg；舒芬太尼联合盐酸曲马多组（对照组）40例：给予舒芬太尼50 μg+盐酸曲马多1 g+托烷司琼10 mg。两组静脉镇痛泵设置为背景剂量2 ml/h，自控给药量1 ml每次，锁定时间15 min。观察两组术后6、12、24、48 h的生命体征、镇痛、镇静评分、按压次数、药物用量、不良反应发生率及镇痛满意度。
结果两组术后镇痛效果差异无统计学意义（P>0.05），但观察组6 h时镇静评分明显低于对照组（P＜0.05）；有效与实际按压次数之比在6和12 h，观察组显著高于对照组（P＜0.05）；各时段镇痛药的用药量和不良反应比较，在6和12 h，用药量及恶心呕吐的发生率观察组均显著低于对照组（P＜0.05）。
结论地佐辛联合盐酸曲马多用于肺癌患者术后静脉自控镇痛效果与舒芬太尼联合盐酸曲马多相同，但是镇静效果更好，且不良反应发生率低。
Abstract:ObjectiveTo investigate the efficacy and safety of Dezocine combined with Tramadol in intravenous patient-controlled analgesia for the lung cancer patients.
MethodsEighty American Society of Anesthesia(ASA) patients undergoing thoracotomy were randomly divided into two groups: Dezocine plus Tramadol group(Observation group) (Dezocine 25mg+Tramadol 1g+tropisetron 10mg, n=40), and Sufentanil plus Tramadol group（Control group）(Sufentanil 50μg and Tramadol 1g+ tropisetron 10mg, n=40). In both groups, the background infusion was 2ml/h and bolus was 1ml with a locktime of 15 minutes. Observations were made at 6, 12, 24 and 48h after surgery monitoring postsurgical stats such as vitals, pain levels, medical dosage, etc. VAS and Ramsey scale were used to evaluate the analgesia response and sedation. Adverse effects and PCIA（patient-controlled intravenous analgesia）numbers were also recorded.
ResultsThere was no significant difference in the score of visual analogue scales (VAS) between two groups (P>0.05). The Ramsay score in the control group was significantly higher than that in the Dezocine plus Tramadol group at 6h after operation (P<0.05). The PCA numbers in the control group was significantly higher than that in the Dezocine plus Tramadol group, at 6 and 12h postoperatively (P<0.05). The incidence of nausea and vomiting in the control group was significantly higher than that in Dezocine plus Tramadol group, at 6 and 12h postoperatively (P<0.05).
ConclusionCompared with Sufentanil, Dezocine combined with Tramadol demonstrates similar effects on postoperative intravenous patient-controlled anesthesia for lung cancer patients. Moreover, it has shown better sedative effect and low incidence of adverse reactions.
-
Key words:
- Dezocine /
- Tramadol /
- Sufentanil /
- Patient-controlled intravenous analgesia
-
-
表 2 两组患者术后不同时段MAP、HR、SpO2、RR变化(x±s)
Table 2 Comparison of postoperative general data, MAP, HR, SpO2, RR, at different time between two groups (x±s)
下载: 导出CSV
-
[1] 李楠, 王平英. 地佐辛用于腹部全麻手术后的镇痛效果评价[J]. 中国生化药物杂志, 2014, 34(7): 156-7. http://www.cnki.com.cn/Article/CJFDTOTAL-SHYW201407049.htm Li N, Wang PY. Analgesic effect evaluation of dezocine in postoperative analgesia in abdominal surgery[J]. Zhongguo Sheng Hua Yao Wu Za Zhi, 2014, 34(7): 156-7. http://www.cnki.com.cn/Article/CJFDTOTAL-SHYW201407049.htm
[1] Li N, Wang PY. Analgesic effect evaluation of dezocine in postoperative analgesia in abdominal surgery[J]. Zhongguo Sheng Hua Yao Wu Za Zhi, 2014, 34(7): 156-7. [李楠, 王平英. 地佐辛 用于腹部全麻手术后的镇痛效果评价[J]. 中国生化药物杂志, 20 14, 34(7): 156-7.] [2] 章玲宾, 王伟玲, 兰群飞. 地佐辛在剖宫产术后硬膜外镜痛中的应用[J]. 中国中西医结合外科杂志, 2012, 18(3): 306-8. http://www.cnki.com.cn/Article/CJFDTOTAL-ZGZX201203045.htm Zhang LB, Wang WL, Lan QF. Epidural analgesia effects of docozine on postoperative pain after caesarean delivery[J]. Zhongguo Zhong Xi Yi Jie He Wai Ke Za Zhi, 2012, 18(3): 306-8. http://www.cnki.com.cn/Article/CJFDTOTAL-ZGZX201203045.htm
[2] Zhang LB, Wang WL, Lan QF. Epidural analgesia effects of docozine on postoperative pain after caesarean delivery[J]. Zhongguo Zhong Xi Yi Jie He Wai Ke Za Zhi, 2012, 18(3): 306-8. [章玲宾, 王伟玲, 兰群飞. 地佐辛在剖宫产术后硬膜外镜痛中 的应用[J]. 中国中西医结合外科杂志, 2012, 18(3): 306-8.] [3] 陈齐, 宋永生,张野. 右美托咪定对开胸术后患者舒芬太尼镇痛效应的影响[J]. 中国疼痛医学杂志, 2012, 18(12): 759-61. http://www.cnki.com.cn/Article/CJFDTOTAL-ZTYZ201212020.htm Chen Q, Song YS, Zhang Y. Effect of Dexmedetomidine for the patients after thoracotomy analgesic with Sufentanil[J]. Zhongguo Teng Tong Yi Xue Za Zhi, 2012, 18(12): 759-61. http://www.cnki.com.cn/Article/CJFDTOTAL-ZTYZ201212020.htm
[3] Chen Q, Song YS, Zhang Y. Effect of Dexmedetomidine for the patients after thoracotomy analgesic with Sufentanil[J]. Zhongguo Teng Tong Yi Xue Za Zhi, 2012, 18(12): 759-61. [陈齐, 宋永生, 张野. 右美托咪定对开胸术后患者舒芬太尼镇痛效应的影响 [J] 中国疼痛医学杂志, 2012, 18(12): 759-61.] [4] Wang WY. Effect analgesic of Dezocine, Fetanil, Fetanil combined with Tramadol on panhysterectomy[J]. Xian Dai Shi Yong Yi Xue, 20 14, 26(12): 1524-6. [王文勇. 地佐辛、芬太尼、芬太尼联合 曲马多在全子宫切除术后镇痛中的效果分析[J]. 现代实用医 学, 2014, 26(12): 1524-6.] [4] 王文勇. 地佐辛、芬太尼、芬太尼联合曲马多在全子宫切除术后镇痛中的效果分析[J]. 现代实用医学, 2014, 26(12): 1524-6. http://www.cnki.com.cn/Article/CJFDTOTAL-NBYX201412036.htm Wang WY. Effect analgesic of Dezocine, Fetanil, Fetanil combined with Tramadol on panhysterectomy[J]. Xian Dai Shi Yong Yi Xue, 2014, 26(12): 1524-6. http://www.cnki.com.cn/Article/CJFDTOTAL-NBYX201412036.htm
[5] 董维森, 李洁, 陈赫军, 等. 地佐辛注射液治疗肿瘤患者持续疼痛的系统评价[J]. 中国疼痛医学杂志, 2016, 22(2): 123-7. http://www.cnki.com.cn/Article/CJFDTOTAL-ZTYZ201602015.htm Dong WS, Li J, Chen HJ, et al. Systematic review of dezoeine injection for persistent pain in cancer patients[J]. Zhongguo Teng Tong Yi Xue Za Zhi, 2016, 22(2): 123-7. http://www.cnki.com.cn/Article/CJFDTOTAL-ZTYZ201602015.htm
[5] Dong WS, Li J, Chen HJ, et al. Systematic review of dezoeine injection for persistent pain in cancer patients[J]. Zhongguo Teng Tong Yi Xue Za Zhi, 2016, 22(2): 123-7. [董维森, 李洁, 陈赫军, 等. 地佐辛注射液治疗肿瘤患者持续疼痛的系统评价[J]. 中国 疼痛医学杂志, 2016, 22(2): 123-7.] [6] 周攀科, 兰志勋. 地佐辛用于术后镇痛的研究进展[J]. 实用医院临床杂志, 2011, 8(6): 169-71. http://www.cnki.com.cn/Article/CJFDTOTAL-YYLC201106068.htm Zhou PK, Lan ZX. Research progress of Dezocine on postoperative analgesia[J]. Shi Yong Yi Yuan Lin Chuang Za Zhi, 2011, 8(6): 169-71. http://www.cnki.com.cn/Article/CJFDTOTAL-YYLC201106068.htm
[6] Zhou PK, Lan ZX. Research progress of Dezocine on postoperative analgesia[J]. Shi Yong Yi Yuan Lin Chuang Za Zhi, 2011, 8(6): 16 9-71. [周攀科, 兰志勋. 地佐辛用于术后镇痛的研究进展[J]. 实用医院临床杂志, 2011, 8(6): 169-71.] [7] Wang YJ, Yang GY, Luo L, et al. Effect observation of Patientcontrolled Venous Analgesia with Tamadol combined with Sufentanil undergoing Uterine Arterial Embolization[J]. Chongqing Yi Xue, 2014, 43(18): 2346-8. [王玉洁, 杨贵英, 罗利, 等. 曲马多联合舒芬太尼对子宫动脉栓塞术后的自控静脉镇痛 效果观察[J]. 重庆医学, 2014, 43(18): 2346-8.] [7] 王玉洁, 杨贵英, 罗利, 等. 曲马多联合舒芬太尼对子宫动脉栓塞术后的自控静脉镇痛效果观察[J]. 重庆医学, 2014, 43(18): 2346-8. http://www.cnki.com.cn/Article/CJFDTOTAL-CQYX201418030.htm Wang YJ, Yang GY, Luo L, et al. Effect observation of Patient-controlled Venous Analgesia with Tamadol combined with Sufentanil undergoing Uterine Arterial Embolization[J]. Chongqing Yi Xue, 2014, 43(18): 2346-8. http://www.cnki.com.cn/Article/CJFDTOTAL-CQYX201418030.htm
[8] Wan HF, Qu PS, Wang GX, et al. Comparison of clinical effect of intravenous dezocine combined with tramadol on elderly patent control intravenous analgesia[J]. Zhongguo Xian Dai Yi Sheng, 20 12, 50(2): 82-4. [万海方, 曲丕盛, 汪国香, 等. 地佐辛联合曲 马多用于老年患者术后静脉镇痛的临床效果观察[J]. 中国现代 医生, 2012, 50(2): 82-4.] [8] 万海方, 曲丕盛, 汪国香, 等. 地佐辛联合曲马多用于老年患者术后静脉镇痛的临床效果观察[J]. 中国现代医生, 2012, 50(2): 82-4. http://www.cnki.com.cn/Article/CJFDTOTAL-ZDYS201202040.htm Wan HF, Qu PS, Wang GX, et al. Comparison of clinical effect of intravenous dezocine combined with tramadol on elderly patent control intravenous analgesia[J]. Zhongguo Xian Dai Yi Sheng, 2012, 50(2): 82-4. http://www.cnki.com.cn/Article/CJFDTOTAL-ZDYS201202040.htm
[9] 燕翔. 为剖宫产术后产妇联合应用地佐辛和曲马多进行静脉自控镇痛的效果研究[J]. 当代医药论丛, 2014, 12(19): 222-3. http://www.cnki.com.cn/Article/CJFDTOTAL-QYWA201419195.htm Yan X. Effect of Patient-controlled Intravenous Analgesia with Dezocine combined with Tamadol for the puerperas undergoing cesarean operation[J]. Dang Dai Yi Yao Lun Cong, 2014, 12(19): 222-3. http://www.cnki.com.cn/Article/CJFDTOTAL-QYWA201419195.htm
[9] Yan X. Effect of Patient-controlled Intravenous Analgesia with Dezocine combined with Tamadol for the puerperas undergoing cesarean operation[J]. Dang Dai Yi Yao Lun Cong, 20 14, 12(19): 222-3. [燕翔. 为剖宫产术后产妇联合应用地佐 辛和曲马多进行静脉自控镇痛的效果研究[J]. 当代医药论丛, 20 14, 12(19): 222-3.] [10] 蒋大明, 鲁振, 王丽君. 地佐辛与氟比洛芬酯或曲马多联合用于肺癌胸腔镜手术术后镇痛的临床观察[J]. 肿瘤基础与临床, 2014, 27(6): 509-11. http://www.cnki.com.cn/Article/CJFDTOTAL-HLZL201406019.htm Jiang DM, Lu Z, Wang LJ. Effects of dezocine combined with flurbiprofen axetil or tramadol in the postoperative analgesia of patients treated with thorascopic surgery[J]. Zhong Liu Ji Chu Yu Lin Chuang, 2014, 27(6): 509-11. http://www.cnki.com.cn/Article/CJFDTOTAL-HLZL201406019.htm
[10] Jiang DM, Lu Z, Wang LJ. Effects of dezocine combined with flurbiprofen axetil or tramadol in the postoperative analgesia of patients treated with thorascopic surgery[J]. Zhong Liu Ji Chu Yu Lin Chuang, 2014, 27(6): 509-11. [蒋大明, 鲁振, 王丽君. 地佐辛 与氟比洛芬酯或曲马多联合用于肺癌胸腔镜手术术后镇痛的 临床观察[J]. 肿瘤基础与临床, 2014, 27(6): 509-11.] [11] Pan B. Clinical efficiency of postoperative analgesia with dezocine, fentanyl and fentanyl combined with tramadol after hysterectomy[J]. Zhongguo Quan Ke Yi Xue, 2011, 9(1): 31, 98. [潘 蓓. 地佐辛、芬太尼及芬太尼联合曲马多用于全子宫切除术后 镇痛的临床效果比较[J]. 中国全科医学, 2011, 9(1): 31, 98.] [11] 潘蓓. 地佐辛、芬太尼及芬太尼联合曲马多用于全子宫切除术后镇痛的临床效果比较[J]. 中国全科医学, 2011, 9(1): 31, 98. http://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201101019.htm Pan B. Clinical efficiency of postoperative analgesia with dezocine, fentanyl and fentanyl combined with tramadol after hysterectomy[J]. Zhongguo Quan Ke Yi Xue, 2011, 9(1): 31, 98. http://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201101019.htm
[12] Zhang B, Zhang WD, Yun WF, et al. Effect of low dose naloxone on analgesia and side effects of postoperative sufentanil[J]. Lin Chuang Ma Zui Xue Za Zhi, 2010, 26(9): 775-6. [张葆, 张卫东, 恽伟方, 等. 小剂量纳洛酮对舒芬太尼术后镇痛及不良反应的 影响[J] 临床麻醉学杂志, 2010, 26(9): 775-6.] [12] 张葆, 张卫东, 恽伟方, 等. 小剂量纳洛酮对舒芬太尼术后镇痛及不良反应的影响[J]. 临床麻醉学杂志, 2010, 26(9): 775-6. http://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ201009018.htm Zhang B, Zhang WD, Yun WF, et al. Effect of low dose naloxone on analgesia and side effects of postoperative sufentanil[J]. Lin Chuang Ma Zui Xue Za Zhi, 2010, 26(9): 775-6. http://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ201009018.htm
计量
- 文章访问数: 1979
- HTML全文浏览量: 441
- PDF下载量: 451
