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地佐辛患者自控硬膜外镇痛在全子宫肌层切除术患者术后镇痛中的应用

Application of dezocine patient-controlled epidural analgesia in postoperative analgesia in patients with total myomectomy.

作者信息

Ning Feng-Feng, Yao Ting-Ting, Wang Xiao-Xia

机构信息

Department of Anesthesiology, Gansu Provincial Maternity and Child-care Hospital, Lanzhou 730050, Gansu Province, China.

Department of Gynecology, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou 730050, Gansu Province, China.

出版信息

World J Clin Cases. 2024 Jul 16;12(20):4265-4271. doi: 10.12998/wjcc.v12.i20.4265.

Abstract

BACKGROUND

Uterine fibroids are common benign gynecological conditions. Patients who experience excessive menstruation, anemia, and pressure symptoms should be administered medication, and severe cases require a total hysterectomy. This procedure is invasive and causes severe postoperative pain, which can affect the patient's postoperative sleep quality and, thus, the recovery process.

AIM

To evaluate use of dezocine in patient-controlled epidural analgesia (PCEA) for postoperative pain management in patients undergoing total myomectomy.

METHODS

We selected 100 patients undergoing total abdominal hysterectomy for uterine fibroids and randomized them into two groups: A control group receiving 0.2% ropivacaine plus 0.06 mg/mL of morphine and an observation group receiving 0.2% ropivacaine plus 0.3 mg/mL of diazoxide in their PCEA. Outcomes assessed included pain levels, sedation, recovery indices, PCEA usage, stress factors, and sleep quality.

RESULTS

The observation group showed lower visual analog scale scores, shorter postoperative recovery indices, fewer mean PCEA compressions, lower cortisol and blood glucose levels, and better polysomnographic parameters compared to the control group ( < 0.05). The cumulative incidence of adverse reactions was lower in the observation group than in the control group ( < 0.05).

CONCLUSION

Dezocine PCEA can effectively control the pain associated with total myomectomy, reduce the negative impact of stress factors, and have less impact on patients' sleep, consequently resulting in fewer adverse effects.

摘要

背景

子宫肌瘤是常见的良性妇科疾病。出现月经过多、贫血及压迫症状的患者应接受药物治疗,严重病例则需行全子宫切除术。该手术具有侵入性,术后会引起剧烈疼痛,这可能影响患者术后睡眠质量,进而影响恢复过程。

目的

评估地佐辛在患者自控硬膜外镇痛(PCEA)中用于子宫肌瘤全子宫切除术后疼痛管理的效果。

方法

我们选取了100例行子宫肌瘤全子宫切除术的患者,将其随机分为两组:对照组在PCEA中接受0.2%罗哌卡因加0.06mg/mL吗啡,观察组在PCEA中接受0.2%罗哌卡因加0.3mg/mL地佐辛。评估的结果包括疼痛程度、镇静情况、恢复指标、PCEA使用情况、应激因素及睡眠质量。

结果

与对照组相比,观察组视觉模拟评分更低、术后恢复指标更短、平均PCEA按压次数更少(<0.05),皮质醇和血糖水平更低,多导睡眠图参数更好(<0.05)。观察组不良反应的累积发生率低于对照组(<0.05)。

结论

地佐辛PCEA能有效控制子宫肌瘤全子宫切除术后的疼痛,减轻应激因素的负面影响,对患者睡眠影响较小,不良反应较少。

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