Effect of Dezocine Combined with Tramadol in Intravenous Patient-controlled Analgesia for Lung Cancer Patients after Thoracotomy
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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.
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Key words:
- Dezocine /
- Tramadol /
- Sufentanil /
- Patient-controlled intravenous analgesia
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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)
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