Department of Anesthesiology, Xuzhou Central Hospital, Affiliated Hospital of Southeast University, China.
Department of Anesthesiology, Xuzhou Central Hospital, Affiliated Hospital of Southeast University, China.
Int J Surg. 2017 Jan-Dec;37 Suppl 1:539-545. doi: 10.1016/j.ijsu.2017.09.079. Epub 2017 Oct 31.
The incidence of reproductive system tumors in Chinese females is increasing year by year, with the trend of younger onset ages. Laparoscopic surgery has been recognized by the majority of medical staff and patients, but the postoperative pain still exists. Therefore, it has become the focus of attention of medical workers to take effective analgesia measures to alleviate postoperative pain as well as to improve the degree of comfort and satisfaction for the patients.
The research objective was to study the effect of different doses of dezocine preemptive analgesia on the safety and the pain post laparoscopic surgeries, in order to explore the best dose of dezocine for postoperative analgesia in gynecological laparoscopic surgeries.
Gynecological laparoscopic surgery patients conformed to the criteria (n = 390) were randomly divided into three groups (group A, B and C) by the methods of randomized, double-blind studies. 0.1 mg/kg, 0.15 mg/kg or 0.2 mg/kg dezocine was intravenously injected 15 min before surgeries for preemptive analgesia. VAS score, Ramsay score and MMSE score were used to evaluate the efficacy and safety of dezocine in preemptive analgesia and sedation, and the use of adjuvant analgesic drugs and the incidence of adverse reactions were also observed.
The VAS scores of the 0.15 mg/kg and 0.2 mg/kg dezocine groups were significantly lower than that of the 0.1 mg/kg group at 2h, 4h, 6h, 8h, 12h and 24h post-surgery, and the difference was statistically significant (p < 0.05). There was no statistically significant difference between the 0.15 mg/kg and 0.2 mg/kg groups (p > 0.05) except for the 12h time point. The MMSE scores 12h post-surgery of the three groups were compared with those 12h prior-to-surgery, and the differences were not statistically significant (p > 0.05) and no increase in the incidence of cognitive impairment was observed. The use rate of analgesic drugs in the 0.1 mg/kg group was significantly higher than those in the 0.15 mg/kg and 0.2 mg/kg groups, and the difference was statistically significant (p < 0.05). There were no significant differences in the incidence of adverse events between the three groups (P > 0.05).
The analgesia and sedation effects of dezocine were enhanced with the increase of usage dose, which suggested that the effects of dezocine were dose-dependent. Intravenous injection of 0.15 mg/kg dezocine 15 min before gynecological laparoscopic surgery showed better analgesic and sedative effects as well as less adverse reactions, and should be the appropriate dose to be used in the preemptive analgesia in gynecological laparoscopic surgeries.
中国女性生殖系统肿瘤的发病率逐年上升,且发病年龄呈年轻化趋势。腹腔镜手术已被大多数医护人员和患者所认可,但术后疼痛仍然存在。因此,采取有效的镇痛措施来减轻术后疼痛,提高患者的舒适度和满意度,已成为医护人员关注的焦点。
研究不同剂量地佐辛超前镇痛对妇科腹腔镜术后安全性及疼痛的影响,旨在探讨妇科腹腔镜手术中地佐辛最佳术后镇痛剂量。
采用随机、双盲研究方法,将符合标准的妇科腹腔镜手术患者(n=390)分为三组(A、B、C 组),分别静脉注射 0.1mg/kg、0.15mg/kg、0.2mg/kg 地佐辛进行超前镇痛。采用视觉模拟评分(VAS)、 Ramsay 评分和简易精神状态检查(MMSE)评分评估地佐辛超前镇痛和镇静的效果及辅助镇痛药物的使用情况,观察不良反应的发生率。
术后 2h、4h、6h、8h、12h、24h 时,0.15mg/kg 和 0.2mg/kg 地佐辛组的 VAS 评分均明显低于 0.1mg/kg 组,差异有统计学意义(p<0.05);0.15mg/kg 和 0.2mg/kg 组之间除 12h 时间点外,差异无统计学意义(p>0.05)。三组患者术后 12h 的 MMSE 评分与术前 12h 比较,差异无统计学意义(p>0.05),未出现认知功能损害增加。0.1mg/kg 组镇痛药使用率明显高于 0.15mg/kg 和 0.2mg/kg 组,差异有统计学意义(p<0.05)。三组不良反应发生率比较,差异无统计学意义(P>0.05)。
地佐辛的镇痛和镇静作用随剂量增加而增强,提示地佐辛的作用呈剂量依赖性。妇科腹腔镜手术前 15min 静脉注射 0.15mg/kg 地佐辛,镇痛镇静效果较好,不良反应较少,应为妇科腹腔镜手术中地佐辛超前镇痛的适宜剂量。