地佐辛预防瑞芬太尼复合麻醉患者术后痛觉过敏的效果

周红艳

[摘要] 目的 探讨地佐辛预防瑞芬太尼复合麻醉患者术后痛觉过敏的临床效果。 方法 收集2011年10月～2012年10月于我院行腹部手术ASAⅠ～Ⅱ级患者72例，随机分为观察组与对照组各36例。两组患者均给予静脉复合麻醉，手术中持续微泵泵入丙泊酚与瑞芬太尼，并间断注射维库澳铵维持麻醉，观察组于手术结束前给予地佐辛预防术后痛觉过敏，对照组不给予地佐辛。比较两组患者术后拔管时间、自主呼吸及意识恢复时间，并比较术后疼痛评分。 结果 观察组患者在自主呼吸恢复时间、意识恢复时间、拔除气管导管时间为（6.27±2.62）min、（8.34±2.43）min、（9.38±3.08）min与对照组（5.89±2.21）min、（8.16±2.10）min、（9.21±3.12）min相比较差异无统计学意义（P>0.05）。观察组33例患者VRS评分为0分，对照组0例患者VRS评分为0分，两组比较差异具有统计学意义（t=11.53， P<0.05）。结论 地佐辛在预防瑞芬太尼复合麻醉患者术后痛觉过敏方面效果明显，可有效减轻患者疼痛感，利于术后恢复，值得临床推广。

[关键词] 地佐辛；瑞芬太尼复合麻醉；痛觉过敏；预防效果

[中图分类号] R614 [文献标识码] B [文章编号] 2095-0616（2014）17-94-03

[Abstract] Objective To investigate the clinical effects of dezocine in preventing postoperative hyperalgesia in the patients receiving remifentanil combined anesthesia. Methods Seventy-two patients with ASA I-II who received abdominal surgery in our hospital from October 2011 to October 2012 were collected and randomly divided into the observation group and the control group， with 36 patients in each group. Both groups were given intravenous combined anesthesia， intraoperative continuous micropumping of propofol and remifentanil and intermittent injection of vecuronium bromide in order to maintain anesthesia. The observation group was given dezocine before the end of surgery to prevent postoperative hyperpathia and the control group was not given dezocine. The postoperative extubation time， autonomous respiration time， consciousness recovery time and pain scores of the two groups were compared. Results The autonomous respiration time， consciousness recovery time and extubation time of the observation group were （6.27±2.62） minutes，（8.34±2.43）minutes and（9.38±3.08） minutes，which were significantly different from the （5.89±2.21） minutes，（8.16±2.10） minutes and （9.21±3.12） minutes of the control group （P>0.05）. Thirty-three patients of the observation group had a VRS score of 0 and none of the control group had a VRS score of 0， with statistically significant difference between the two groups （t=11.53， P<0.05）. Conclusion In the prevention of postoperative hyperalgesia in the patients receiving remifentanil combined anesthesia， dezocine shows obvious effects， can effectively relive the patients' pain and is conducive to postoperative recovery， thereby worthy of clinical promotion.

[Key words] Dezocine； Remifentanil anesthesia； Hyperalgesia； Preventive effect

瑞芬太尼属于阿片类镇痛药物范畴，是最新应用于临床的超短效镇痛药，其优点是起效快、清除速度快及较长时间内输注在人体内无蓄积，因此在临床得到了广泛的应用[1-2]。但是也有明显的缺点，代谢速度快，麻醉停止后药物的镇痛作用会迅速减弱并消失，使患者术后疼痛，严重者会引起痛觉过敏[3]。本次研究旨在探讨地佐辛预防瑞芬太尼复合麻醉患者术后痛觉过敏的临床效果，报道如下。

1 资料与方法

1.1 一般资料

收集2011年10月～2012年10月于我院行腹部手术ASAⅠ～Ⅱ级患者72例，随机分为观察组与对照组，各36例。其中观察组中男30例，女16例；年龄41～73岁，平均（58.2±6.4）岁；对……