摘要
目的:探讨地佐辛用于腹腔镜手术后的镇痛效果及其对炎性因子的影响。方法:选取临海市第一人民医院2017年5月至2019年12月择期行腹腔镜手术患者86例,按照随机数字表法分为对照组(n=43)和观察组(n=43),两组患者在手术完成前15 min静脉输入镇痛液,对照组镇痛液为舒芬太尼+氟比洛芬酯+昂丹司琼。观察组在对照组基础上加地佐辛。比较两组术前、术后48 h血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平变化,比较两组术后2 h、术后12 h、术后24 h的疼痛程度及不良反应发生情况。结果:术前,两组TNF-α、IL-6、MDA、SOD均差异无统计学意义(均P>0.05);术后48 h,观察组TNF-α[(28.92±3.47)pg/L]、IL-6[(67.81±8.14)pg/L]、MDA[(6.37±0.96)mmol/L]均低于对照组[(44.59±4.90)pg/L、(133.52±17.36)pg/L、(10.12±1.21)mmol/L,SOD[(78.35±10.97)U/mL]高于对照组[(57.34±7.45)U/mL],均差异有统计学意义(t=17.114、22.473、15.921、-10.390,均P<0.05)。观察组术后2 h、术后12 h、术后24 h疼痛评分分别为(1.05±0.61)分、(2.25±0.60)分、(1.72±0.62)分,均低于对照组的(1.36±0.48)分、(3.12±0.54)分、(2.37±0.71)分(t=2.619、7.067、4.522,均P<0.05)。观察组恶心、呕吐发生率分别为4.65%(2/43)、0.00%(0/43),均低于对照组的20.93%(9/43)、13.95%(6/43),均差异有统计学意义(χ^(2)=5.108、4.479,均P<0.05)。结论:地佐辛用于腹腔镜手术后镇痛,可减轻患者疼痛程度,抑制术后炎性反应及氧化应激反应。
Objective To investigate the analgesic effect of dezocine after laparoscopic surgery and its effects on inflammatory factors.Methods A total of 86 patients scheduled for laparoscopic surgery in Linhai First People's Hospital from May 2017 to December 2019 were selected and randomly divided into a control group(n=43)and an observation group(n=43).The patients in the two groups were intravenously injected with analgesics 15 minutes before the end of surgery.The analgesics in the control group were sufentanil,flurbiprofen and ondansetron.Sufentanil,flurbiprofen,ondansetron combined with dezocine were used in the observation group.The changes in serum tumor necrosis factor-alpha,interleukin-6,malondialdehyde,superoxide dismutase levels were compared between before and 48 hours after surgery in each group and between the two groups before and 48 hours after surgery.The degree of pain and incidence of adverse reactions were compared between the two groups at 2,12 and 24 hours after surgery.Results Before surgery,there were no significant differences in tumor necrosis factor-alpha,interleukin-6,malondialdehyde and superoxide dismutase levels between the observation and control groups(all P>0.05).At 48 hours after surgery,tumor necrosis factor-alpha[(28.92±3.47)pg/L],interleukin-6[(67.81±8.14)pg/L]and malondialdehyde[(6.37±0.96)mmol/L]levels in the observation group were significantly lower compared with the control group[(44.59±4.90)pg/L,(133.52±17.36)pg/L,(10.12±1.21)mmol/L,t=17.114,22.473,15.921,P<0.05].At 48 hours after surgery,superoxide dismutase level in the observation group was significantly higher than that in the control group[(78.35±10.97)U/mL vs.(57.34±7.45)U/mL,t=-10.390,P<0.05).At 2,12 and 24 hours after surgery,pain score in the observation group(1.05±0.61 points,2.25±0.60 points,1.72±0.62 points,respectively)were significantly lower compared with the control group(1.36±0.48)points,(3.12±0.54)points,(2.37±0.71)points,t=2.619,7.067,4.522,all P<0.05).The incidences of nausea and vomiting in the observation group were significantly lower compared with the control group[nausea:4.65%(2/43)vs.20.93%(9/43),vomiting:0.00%(0/43)vs.13.95%(6/43),χ^(2)=5.108 and 4.479,both P<0.05).Conclusion Dezocine for analgesia after laparoscopic surgery can reduce the degree of pain,inhibit postoperative inflammatory reaction and oxidative stress reaction,and reduce the incidence of adverse reactions.
作者
项万红
郑翔
卢敬利
Xiang Wanhong;Zheng Xiang;Lu Jingli(Department of Anesthesiology,Linhai First People's Hospital,Linhai 317000,Zhejiang Province,China)
出处
《中国基层医药》
CAS
2021年第1期71-75,共5页
Chinese Journal of Primary Medicine and Pharmacy
