| 周亚丽,赵璐,向竞.不同剂量地佐辛对吗啡鞘内镇痛的影响.[J].中南医学科学杂志.,2021,(4):452-455. |
| 不同剂量地佐辛对吗啡鞘内镇痛的影响 |
| Effects of different doses of dezocine on morphine intrathecal analgesia |
| 投稿时间：2021-01-19 修订日期：2021-03-16 |
| DOI：10.15972/j.cnki.43-1509/r.2021.04.019 |
| 中文关键词: 不同剂量 地佐辛 吗啡 镇痛 |
| 英文关键词:different doses dezocine morphine analgesia |
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| 中文摘要: |
| 目的观察不同剂量地佐辛对吗啡鞘内镇痛的影响。方法选择90例接受开胸肺叶切除术的患者随机均分为吗啡组、地佐辛低剂量组和地佐辛高剂量组,吗啡组患者术毕鞘内注射0.2 mg吗啡,在吗啡组基础上,地佐辛低剂量组、地佐辛高剂量组患者均连接静脉镇痛泵,分别应用地佐辛每天0.1 mg/kg和0.3 mg/kg,比较3组患者术中舒芬太尼用量和术后吗啡补救用量、术后疼痛情况和镇静效果、肾上腺素与去甲肾上腺素水平、不良反应等。结果3组患者术中舒芬太尼用量差异无统计学意义(P＞0.05),地佐辛低剂量组和地佐辛高剂量组术后24 h、48 h补救吗啡用量均显著低于吗啡组(P＜0.05)。术后48 h,3组患者VAS评分较术后1 h均显著降低(P＜0.05),镇静评分较术后1 h降低,但差异无统计学意义(P＞0.05)。术后24 h,3组患者血浆肾上腺素、去甲肾上腺素水平较术后2 h均显著升高(P＜0.05),但地佐辛低剂量组、地佐辛高剂量组术后24 h的血浆肾上腺素、去甲肾上腺素水平显著低于吗啡组(P＜0.05),而地佐辛低剂量组、地佐辛高剂量组差异无统计学意义(P＞0.05)。地佐辛低剂量组和地佐辛高剂量组不良反应发生率均显著低于吗啡组(P＜0.05),但地佐辛低剂量组和地佐辛高剂量组差异无统计学意义(P＞0.05)。结论联合应用不同剂量地佐辛和吗啡均可获得良好术后镇痛效果,有利于减少术后吗啡补救用量、降低肾上腺素和去甲肾上腺素水平,减少不良反应。 |
| 英文摘要: |
| To explore the effect of different doses of dezocine on intrathecal morphine analgesia. Methods90 patients undergoing thoracotomy lobectomy were randomly divided into morphine group, low dose dezocine group and high dose dezocine group, 30 cases in each group, The dosage of sufentanil and morphine, postoperative pain and sedative effect, epinephrine and norepinephrine levels, and adverse reactions were compared among three groups.ResultsThere was no significant difference in the amount of sufentanil used in three groups (P＞0.05). The amount of morphine used 24 and 48 hours after operation in low dose dezocine group and high dose dezocine group was significantly lower than that in morphine group (P＜0.05). Within 48 hours after operation, the VAS score of three groups were significantly lower than those at 1 hour after operation (P＜0.05), sedation score was lower than in after operation, but the diffence was not stcotisticall significant (P＞0.05). At 24 h after operation, the levels of plasma adrenaline and noradrenaline in three groups were significantly higher than those at 2 h after operation (P＜0.05), but the levels of plasma adrenaline and noradrenaline at 24 h after operation in low dose dezocine group and high dose dezocine group were significantly lower than those in morphine group (P＜0.05), while there was no significant difference between low dose dezocine group and high dose dezocine group (P＜0.05); The incidence of adverse reactions in low dose dezocine group and high dose dezocine group was significantly lower than that in morphine group (P＜0.05), but there was no significant difference between low dose dezocine group and high dose dezocine group (P＞0.05). ConclusionThe combined use of different doses of dezocine and morphine can obtain good postoperative analgesia effect, which is conducive to reduce the salvage dose of morphine, lower the level of plasma adrenaline, noradrenaline and reduce the adverse reactions. |
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