地佐辛复合舒芬太尼麻醉用于妇科腔镜下输卵管切除术后静脉镇痛效果研究

摘要

目的 研究舒芬太尼联合地佐辛在妇科腔镜下进行输卵管切除术的镇痛效果.方法 选择2013年4月~2014年12月在海宁市中心医院手术的188例输卵管妊娠患者,随机分为2组,每组94例.在常规静脉镇痛的基础上,对照组单独采用舒芬太尼,观察组患者加用地佐辛.比较2组患者手术后不同时间点的疼痛评分、Ramsay镇静评分以及、IL-6和IL-10水平,并比较2组患者的不良反应发生情况.结果 观察组患者术后4h、8h、12h及24h的VAS评分显著低于对照组,2组间比较差异明显(P<0.05),2组患者48h的VAS评分基本相当;2组观察组4h、8h、12h、24h和48h五个时间点Ramsay评分显著高于对照组,差异有统计学意义(P<0.05);2组患者在术后24h和48h的IL-6水平均显著高于术前,观察组低于同期对照组,2组差异有统计学意义(P<0.05);2组患者手术后24h和48h IL-10均高于手术前,且观察组的水平高于同期对照组,差异有统计学意义(P<0.05);2组患者不良反应均以头晕、恶心、皮肤瘙痒和嗜睡为主,观察组不良反应发生率为12.8%,低于对照组的29.8%,2组比较差异有统计学意义(P<0.05).结论 在妇科腔镜下切除输卵管手术后的镇痛过程中,地佐辛联合舒芬太尼具有良好的镇痛效果,患者VAS镇痛评分及Ramsay镇静评分改善更明显,炎症因子水平更低,炎症保护作用更强,且患者不良反应发生率明显降低,是一种可靠的临床静脉镇痛方法.%Objective To study the analgesic effect of sufentanil combined with Dezocine in endoscopic resection of fallopian.MethodsA total of 188 patients with tubal pregnancy from April 2013 to December 2014 in Haining central hospital were enrolled in the study, they were randomly divided into two groups (n=94).On the basis of conventional intravenous analgesia, the patients in control group was were received sufentan, the observation group were given sufentan combined with dezocine.The score of pain at different time points after operation, the Ramsay sedation score, and the level of IL-6 and IL-10 were compared.The adverse reactions were compared between the two groups.ResultsThe score of VAS in the observation group was significantly lower than that in the control at 4h, 8h, 12h and 24h after operation (P<0.05).The score of VAS in the two groups were similar at 48h after operation;the Ramsay score in the observation group was significantly higher than that in the control group(P<0.05) at five time points (4h, 8h, 12h, 24h and 48h after operation);when compared Compared with the indexes before operation, the level of IL-6 was significantly increased in the two groups at 24h and 48h, but the observation group increased less, the IL-6 in observation group was lower than that in the control group at the two points(P<0.05);while the IL-10 was higher than that beforeoperation, and the observation group was more higher(P<0.05).The adverse reactions in the two groups were mainly dizziness, nausea, pruritus and lethargy, and the incidence was only 12.8% in the observation group, which lower than that in the control of 29.8%(P<0.05).ConclusionIt which dazocine combined with sufentanil had a good analgesic effect in the process of analgesia in gynecological laparoscopic resection of fallopian tube after the operation.The VAS score and Ramsay sedation score was improved significantly.The levels of inflammatory factors were lower, and the incidence of adverse reaction was significantly reduced.It is a reliable method for clinical intravenous analgesia.