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目的观察地佐辛注射液与舒芬太尼注射液对小儿全麻术后的镇痛效果及安全性。方法 78例在全麻下择期进行疝囊结扎手术患儿,随机分为对照组39例与试验组39例。对照组静脉注射枸橼酸舒芬太尼注射液0.5~1.0μg·kg~(-1)+地塞米松注射液0.1~0.2 mg·kg~(-1);试验组静脉注射地佐辛注射液0.15~0.2 mg·kg~(-1)+地塞米松注射液0.1~0.2 mg·kg~(-1)。比较2组患儿的临床疗效、治疗前后血清超敏C-反应蛋白(hs-CRP)、肌酸激酶同工酶(CK-MB)水平,以及药物不良反应发生情况。结果治疗后,对照组的总有效率为76.92%(30/39例),试验组为94.87%(37/39例),差异有统计学意义(P<0.05)。术后24,72 h对照组血清hs-CRP水平分别为(37.29±3.98),(97.29±10.27)mg·L~(-1),试验组分别为(24.29±2.58),(90.29±10.18)mg·L~(-1)(P<0.05)。术后120 h,对照组和试验组血清hs-CRP水平分别为(19.29±2.10),(22.18±2.37)mg·L~(-1)(P<0.05)。术后各时间段CK-MB水平差异无统计学意义(P>0.05)。试验组出现恶心呕吐1例,皮肤瘙痒1例,嗜睡1例,药物不良反应发生率为7.69%(3/39例);对照组出现恶心呕吐2例,皮肤瘙痒2例,嗜睡1例,尿潴留1例,药物不良反应发生率为15.38%(6/39例),2组药物不良反应发生率比较,差异无统计学意义(P>0.05)。结论与舒芬太尼注射液相比,地佐辛注射液对小儿全麻术后镇痛的临床疗效显著,安全性相似。
Objective To observe the analgesic effect and safety of dezocine injection and sufentanil injection on pediatric general anesthesia. Methods Seventy-eight children undergoing selective ligation of hernia sac under general anesthesia were randomly divided into control group (n = 39) and experimental group (n = 39). The control group received sufentanil citrate 0.5-1.0 μg · kg -1 and dexamethasone 0.1-0.2 mg · kg -1 intravenously Solution 0.15 ~ 0.2 mg · kg ~ (-1) + dexamethasone 0.1 ~ 0.2 mg · kg ~ (-1). The clinical efficacy, serum hs-CRP, CK-MB levels and adverse drug reactions in both groups were compared before and after treatment. Results After treatment, the total effective rate of the control group was 76.92% (30/39 cases), the experimental group was 94.87% (37/39 cases), the difference was statistically significant (P <0.05). The levels of serum hs-CRP in the control group at 24 and 72 h after operation were (37.29 ± 3.98) and (97.29 ± 10.27) mg · L -1, respectively, and those in the test group were (24.29 ± 2.58) and (90.29 ± 10.18) mg · L -1 (P <0.05). The levels of hs-CRP in control group and experimental group were (19.29 ± 2.10) and (22.18 ± 2.37) mg · L -1, respectively (P <0.05) at 120 h after operation. There was no significant difference in CK-MB level after operation (P> 0.05). One case of nausea and vomiting, one case of pruritus, one case of lethargy and one case of drowsiness, the rate of ADR was 7.69% (3/39 cases). In the control group, nausea and vomiting occurred in 2 cases, pruritus in 2 cases, drowsiness in 1 case, urine 1 case of retention, the incidence of adverse drug reactions was 15.38% (6/39 cases), two groups of drug adverse reactions, the difference was not statistically significant (P> 0.05). Conclusion Compared with sufentanil injection, dezocine injection has obvious clinical efficacy and safety of post-general anesthesia analgesia.