The Effects Of Dezocine Pretreatment On Postoperative Analgesia In Thoracotomy

Objective: To investigate the loading dose Dezocine injectionfor postoperative analgesic efficacy in patients with thoracicobserve patients after different periods of pain visual analoguescale (VAS), Comfort score (BCS) and sedation score (Ramsay)and adverse drug reactions, postoperative analgesia pumppressing circumstances, whether the application of remedialmeasures, analgesic, and provide evidence for the clinicalmanagement of postoperative painMethods:60cases of thoracic surgery were randomly dividedinto three groups, three groups were propofol and remifentanilanesthesia, respectively, before the end of surgery30minutesintravenous dezocine0.2mg/kg (group A), dezocine0.1mg/kg(group B) and saline3ml (group C),20patients in each group,double-blind controlled study. Induction of anesthesia: midazolam0.05mg/kg, fentanyl4ug/kg, etomidate0.2mg/kg, cis-atracurium0.15mg/kg. Maintenance of anesthesia: propofol4~8mg/(kg h), remifentanil0.1~0.2μ g/(kg min) accord surgicalrequirements to adjust the amount of depth of anesthesia andmuscle relaxants, when patients recovery the condition of extubation after surgery (breathing, consciousness, cough andswallowing reflex recovery) extubation, and then connect theanalgesia pump.Postoperative analgesia pump preparation: Sufentanil2μg/kg+Dezocine0.2mg/kg+Ramosetron0.6mg plus saline to100ml, aloading dose of1.5ml, maintain1.5ml/h, the lock15min,additional1ml. In postoperative2,6,12,24and48h hour follow-up,recorded the pain visual analog scale (VAS), a comfortable score(BCS) and sedation score (Ramsay score) and adverse drugreactions (nausea, vomiting, headache, dizziness, lethargy,pruritus, urinary retention, respiratory depression), the situation ofpressure the postoperative analgesia pump, Whether applicationof remedial analgesic action ect.Results: Postoperative2、6、12、24、48h group A、 group BVAS scores were significantly lower than group C P <0.01, after2、6、12h group A VAS score lower than group B, P <0.05, surgeryafter24、48h group A、 group B VAS score showed noabnormalities, P>0.05; postoperative2、6、12、24、48h group A、group B BCS score higher than group C, P <0.05, after2、6hBCS group A score higher than group B, P <0.05, the other point intime no abnormalities; postoperative2、6、12、24、48h group A、group B BCS score than group C P <0.05, after2、6h BCS group A score higher than group B, P <0.05, the other point in time noabnormalities; postoperative2、6、12、24、48h group A、 groupB score Ramsay score than group C, P <0.05, there is nodifference between group A and group B at each time point;during postoperative analgesia three groups of patients, nausea,dizziness number of cases occurred in group A、group B higherthan in group C P <0.05; Compare the postoperative PCIA12、24、48hours on the number of group A is lower than group B P<0.05, group A was significantly lower than in group C， P <0.01,group B than in group C P <0.05; postoperative48h the satisfactionrate of group A is90%, group B is85%, group C is70%, groupA satisfaction rate in group B, group B satisfied than CConclusion:1. in thoracic surgery patients, intravenousinjection0.2mg/kg、0.1mg/kg of Dezocine30min before the end ofsurgery, analgesic effect and sedative effect is better than thesaline control group， Dezocine pretreatment can improve theanalgesic effect of postoperative PCIA.。2.before the end ofsurgery30min to give intravenous Dezocine0.2mg/kg thenconnect PCIA for multimodal analgesia,there is a certain referencevalue for thoracic surgery clinical thoracotomy analgesia，relative to0.1mg/kg of Dezocine does not increase the incidence ofpostoperative adverse events, and the analgesic effect is more stronger.