瑞芬太尼与地佐辛在中期妊娠引产过程中镇痛效果的比较

Effect of remifentanil versus dezocine analgesia in middle pregnancy abortion

  • 摘要:
      目的  比较瑞芬太尼与地佐辛在中期妊娠引产镇痛中的应用效果。
      方法  选择中期妊娠引产患者80例随机分为R组与D组,每组40例。R组采用瑞芬太尼0.05~0.15 μg/(kg·min)微量泵静脉输注镇痛,随时调整用药以达到并维持镇痛所需水平; D组采用地佐辛25 mg, 稀释至50 mL生理盐水中,背景剂量10 mL/h, 单次剂量5 mL/h静脉自控镇痛。记录2组视觉模拟评分法(VAS)疼痛评分、Ramsay镇静评分、镇痛调节次数、引产后第一疼痛时间以及呼吸抑制、心动过缓、恶心呕吐等不良反应发生情况。
      结果  镇痛结束后30 min, R组VAS评分(7.5±1.2)分显著高于D组(2.3±1.1)分(P < 0.05); R组Ramsay评分(2.5±0.2)分显著高于D组(2.3±0.3)分(P < 0.05); R组镇痛调节次数显著多于D组,第一疼痛时间显著短于D组,心动过缓、呼吸抑制的发生率显著高于D组(P < 0.05)。
      结论  与瑞芬太尼相比,地佐辛静脉自控镇痛用于妊娠中期引产操作更方便,孕妇易配合,可避免产生痛觉过敏,且不良反应发生率更低。

     

    Abstract:
      Objective  To compare the effect of remifentanil and dezocine analgesia in middle pregnancy abortion.
      Methods  A total of 80 middle pregnant induced labor cases were randomly divided into group R and group D, with 40 cases in each group. Group R was given intravenous infusion of remifentanil for analgesia at a dosage of 0.05~0.15 μg/(kg·min) by micro pump, and the dosage was adjusted to reach and maintain the level of analgesia. Group D was given 25 mg dezocine diluted to 50 mL normal saline, with abackground dose of 10 mL/h. A single intravenous analgesia dose of 5 mL/h was given to theses patients for intravenous self-controlled analgesia. Visual Analogue Scale (VAS) Scores, Ramsay sedation score, adjust times of analgesia, time to first pain after induction and occurrence of complications such as respiratory depression, bradycardia, nausea and vomiting were recorded.
      Results  At 30 min after analgesia, the VAS score in the R group was significantly higher than that in group D(7.5±1.2) vs. (2.3±1.1), P < 0.05; the Ramsay score in the group R was significantly higher than that in the group D (2.5±0.2) vs. (2.3±0.3), P < 0.05); the times of analgesic adjustment in group R was significantly more, the time to first pain was significantly shorter, and the incidences of bradycardia and respiratory depression were significantly higher than that of group D (P < 0.05).
      Conclusion  Compared with remifentanil, dezocine intravenous analgesia for middle pregnancy abortion women with easy operation and cooperation can avoid the occurrence of hyperalgesia, and reduce incidence of adverse reactions.

     

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