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目的探索地佐辛用于妇科腹腔镜下子宫肌瘤手术全麻术中镇痛及术后泵注镇痛的疗效观察。方法随机将60例子宫肌瘤行手术治疗患者分为观察组(A)及对照组(B),各30例,术前30min肌注阿托品0.5mg、咪达唑仑3mg,A组:全麻诱导用地佐辛0.4mg/kg、丙泊酚2mg/kg、维库溴铵0.12mg/kg;术后静脉泵注地佐辛0.15mg/mL、昂丹司琼4mg、凯酚200mg+0.9%生理盐水至100mL,2mL/h;B组:全麻诱导用芬太尼0.006mg/kg、丙泊酚2mg/kg、维库溴铵0.12mg/kg;术后静脉泵注芬太尼0.003mg/mL、昂丹司琼4mg、凯酚200mg+0.9%生理盐水至100mL,2mL/h,比较两组患者术中镇痛及术后镇痛效果。结果两组患者术中、术后48h内HR、RR、BP等差异均无统计学意义,均P>0.05;观察A组有效镇痛率93.33%(28/30),高于B组的83.33%(25/30),P<0.05;观察组患者不良反应发生率为3.33%(1/30),显著低于B组的16.67%(5/30),P<0.05;术后1、3、6、12、24、36、48h,观察组患者各时间点舒适度均高于B组(均P<0.05)。结论地佐辛具有良好的术中镇痛效果,且不良反应少、术后患者镇痛、舒适度高、应用简便,应予以临床推广应用。
Objective To explore the effect of dezocine for analgesia and postoperative analgesia after general anesthesia for gynecological laparoscopic myomectomy. Methods A total of 60 patients with uterine fibroids were randomly divided into observation group (A) and control group (B), 30 cases in each group. Atropine 0.5 mg and midazolam 3 mg were intramuscularly injected 30 min before operation. Group A: general anesthesia Induction of zooxin 0.4mg / kg, propofol 2mg / kg, vecuronium bromide 0.12mg / kg; intravenous infusion of dezocine 0.15mg / mL, ondansetron 4mg, catechol 200mg + 0.9% Normal saline to 100mL, 2mL / h; Group B: induction of general anesthesia with fentanyl 0.006mg / kg, propofol 2mg / kg, vecuronium 0.12mg / kg; intravenous infusion of fentanyl 0.003mg / mL, ondansetron 4mg, catechol 200mg + 0.9% saline to 100mL, 2mL / h, the two groups were compared intraoperative analgesia and postoperative analgesia. Results There were no significant differences in HR, RR and BP between the two groups within 48 hours after operation, both P> 0.05. The effective analgesic rate of group A was 93.33% (28/30), which was higher than that of group B % (25/30), P <0.05; the incidence of adverse reactions in the observation group was 3.33% (1/30), significantly lower than that in group B (16.67%, 5/30) , 6,12,24,36,48h. The comfort of observation group was higher than that of group B at all time points (all P <0.05). Conclusion Dezocine has good intraoperative analgesic effect, less adverse reactions, postoperative analgesia and high comfort, and its application is simple and should be popularized clinically.