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地佐辛联合舒芬太尼的术后镇痛效果:一项倾向评分匹配研究。

Postoperative analgesic effect of dezocine combined with sufentanil: A propensity score matching study.

作者信息

Li Xinguo, Yang Caiyan, Yan Hui, Suo Xiaobo, Ma Zong, Xu Daqing

机构信息

Department of Pharmacy, Ningxia Hui Autonomous Region Ning'an Hospital, Yinchuan, Ningxia, China.

Department of Pharmacy, Yinchuan First People's Hospital, Yinchuan, Ningxia, China.

出版信息

Medicine (Baltimore). 2025 Jun 27;104(26):e43041. doi: 10.1097/MD.0000000000043041.

Abstract

Postoperative pain can produce a variety of adverse reactions, prolong postoperative recovery time and length of hospital stay and increase medical costs. Postoperative analgesia methods are different; dezocine combined with sufentanil is one such method, but its the efficacy remains uncertain. Therefore, we investigated the clinical efficacy and medical costs of dezocine combined with sufentanil for postoperative analgesia. A retrospective observation and analysis were conducted on all patients admitted to a tertiary hospital in Ningxia Hui Autonomous Region from March 1, 2022 to March 3, 2024 for surgery and postoperative analgesia. Patients were divided into 2 groups according to the treatment of postoperative pain: treatment group (dezocine combined with sufentanil) and control group (conventional sufentanil analgesia). Propensity score matching was performed for sex, age, weight, and analgesic pump parameters (total drug dose, first drug dose, duration of analgesia, patient-controlled drug dose, and infusion rate). After propensity score matching, 1178 patients were included. There were no significant differences in the baseline characteristics between the 2 groups, and the histogram and jitter plots of the propensity score distribution indicated good matching. There was no significant difference in clinical analgesic efficiency (88.5% vs 86.8%), 24 hours analgesic score (0.95 vs 0.95), 48 hours analgesic score (0.58 vs 0.58) and 72 hours analgesic score (0.37 vs 0.37) between the 2 groups. The overall incidence of adverse events (11.4% vs 14.9%, P = .07) was similar between the 2 groups. However, the subgroup analysis showed that the incidence of nausea and vomiting in the control group was higher than that in the treatment group (8.5% vs 5.6%, P = .02), and the incidence of somnolence in the control group was lower than that in the treatment group (2.0% vs 4.4%, P = .02). There was no significant difference in the incidence of vertigo or other adverse reactions between the groups. In addition, the cost of analgesics in the treatment group was significantly higher than that in the control group (the cost of analgesics: 484.74 ± 177.39 in the treatment group VS 83.35 ± 14.55 in the control group), and the difference between the 2 groups was statistically significant (P < .001). Dezocine combined with sufentanil can be used for postoperative analgesia, but this analgesic method has no obvious advantage over sufentanil alone, In addition, it increases the healthcare burden on patients.

摘要

术后疼痛可产生多种不良反应,延长术后恢复时间和住院时长,并增加医疗费用。术后镇痛方法各异,地佐辛联合舒芬太尼即为其中一种方法,但其疗效仍不确切。因此,我们研究了地佐辛联合舒芬太尼用于术后镇痛的临床疗效及医疗费用。对2022年3月1日至2024年3月3日在宁夏回族自治区某三级医院接受手术及术后镇痛的所有患者进行回顾性观察与分析。根据术后疼痛治疗方法将患者分为2组:治疗组(地佐辛联合舒芬太尼)和对照组(常规舒芬太尼镇痛)。对性别、年龄、体重及镇痛泵参数(药物总量、首次给药剂量、镇痛时长、患者自控给药剂量及输注速率)进行倾向得分匹配。倾向得分匹配后,纳入1178例患者。两组间基线特征无显著差异,倾向得分分布的直方图和抖动图显示匹配良好。两组间临床镇痛有效率(88.5%对86.8%)、24小时镇痛评分(0.95对0.95)、48小时镇痛评分(0.58对0.58)及72小时镇痛评分(0.37对0.37)无显著差异。两组间不良事件总发生率相似(11.4%对14.9%,P = 0.07)。然而,亚组分析显示,对照组恶心呕吐发生率高于治疗组(8.5%对5.6%,P = 0.02),对照组嗜睡发生率低于治疗组(2.0%对4.4%,P = 0.02)。两组间眩晕或其他不良反应发生率无显著差异。此外,治疗组镇痛药物费用显著高于对照组(镇痛药物费用:治疗组484.74 ± 177.39,对照组83.35 ± 14.55),两组间差异具有统计学意义(P < 0.001)。地佐辛联合舒芬太尼可用于术后镇痛,但该镇痛方法相较于单独使用舒芬太尼并无明显优势,此外,还增加了患者的医疗负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adbe/12212752/d9fd67574dcb/medi-104-e43041-g001.jpg

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