论文部分内容阅读
目的:观察地佐辛联合小剂量纳洛酮用于甲状腺癌根治术术后镇痛的效果和不良反应。方法:选取全麻下行甲状腺癌根治术且要求进行术后镇痛的患者80例,随机分为地佐辛组(D组)和地佐辛联合纳洛酮组(DN组),每组40例。D组:地佐辛0.4 mg·kg-1,生理盐水稀释至100 m L;DN组:地佐辛0.4mg·kg-1,纳洛酮1μg·kg-1,生理盐水稀释至100 m L。两组均应用患者自控静脉术后镇痛(patient-controlled intravenous analgesia,PCIA),以LCP模式(负荷剂量1 m L,持续剂量1 m L·h-1,患者自控镇痛每次2 m L)输注。记录2组患者术后2,24和48 h的VAS疼痛评分及Ramsay镇静评分、术后48 h内有效PCA按压次数、恶心、呕吐和头晕等镇痛药物不良反应的发生情况以及患者满意度。结果:2组患者术后各时点的VAS评分及48 h内有效PCA按压次数差异无统计学意义。D组患者术后2 h和24 h的Ramsay镇静评分显著高于DN组患者(分别为P=0.036和P=0.012);DN组患者术后48 h内恶心呕吐的发生率明显低于D组(P=0.001);DN组患者术后48 h内头晕的发生率明显低于D组(P=0.043);DN组术后镇痛满意度高于D组(P<0.001)。结论:地佐辛联合小剂量纳洛酮用于甲状腺癌根治术术后镇痛,可降低不良反应的发生率且不影响镇痛效果。
Objective: To observe the effect and side effects of dezocine combined with low-dose naloxone in the postoperative analgesia of radical thyroidectomy. Methods: A total of 80 patients undergoing radical thyroidectomy under general anesthesia and requiring postoperative analgesia were randomly divided into dezocine group (D group) and dezocine combined with naloxone group (DN group), 40 example. Group D: Dezocine 0.4 mg · kg-1, diluted to 100 mL with saline; DN group: Dezocine 0.4 mg · kg-1, naloxone 1 μg · kg-1, diluted to 100 mL with saline . Patient-controlled intravenous analgesia (PCIA) was used in both groups. The LCP model (loading dose 1 m L, continuous dose 1 m L · h-1, patient controlled analgesia 2 m L ) Infusion. VAS pain scores, Ramsay sedation scores, number of effective PCA pressures, nausea, vomiting, and dizziness within 48 hours after operation were recorded at 2, 24, and 48 hours after operation in both groups. The incidence of adverse drug reactions and patient satisfaction were recorded. Results: There was no significant difference in the VAS score between two groups and the number of effective PCA pressing within 48 h after operation. The Ramsay sedation scores of patients in group D at 2 h and 24 h after operation were significantly higher than those in group DN (P = 0.036 and P = 0.012, respectively). The incidence of nausea and vomiting in group D was significantly lower than that of group D (P = 0.001). The incidence of dizziness in DN group was significantly lower than that in D group (P = 0.043) within 48 hours after operation. The satisfaction degree of postoperative analgesia in DN group was higher than that in D group (P <0.001). Conclusion: Dezocine combined with low-dose naloxone for postoperative analgesia of radical thyroidectomy can reduce the incidence of adverse reactions and does not affect the analgesic effect.