石健

[摘要] 目的 探析地佐辛用于下肢骨折患者椎管内麻醉前体位摆放时的镇痛效果。 方法 随机选取2014年6月—2015年6月收治的60例下肢骨折患者，行椎管内麻醉，将其随机分为试验组和对照组，各为30例，椎管内麻醉体位摆放前15 min，试验组给予地佐辛肌注，对照组给予氯化钠注射液，比较两组安静平卧位（T1）、体位摆放时（T2）、腰硬联合麻醉成功后（T3）的数字镇静评分（NSS）、VAS评分的改变情况。 结果 在T1、T2上试验组VAS评分差异不显著；对照组T2时VAS评分较T1时高，P<0.05；试验组T2时的VAS评分较对照组低，P<0.05；试验组发生率3.33%，对照组16.67%，比较差异具有统计学意义（χ2=4.396，P<0.05）。 结论 地佐辛用于下肢骨折患者椎管内麻醉前，减轻体位摆放时疼痛，并发症少，值得应用。

[关键词] 地佐辛；下肢骨折；椎管内麻醉

[中图分类号] R614 [文献标识码] A [文章编号] 1674-0742（2016）02（b）-0122-03

[Abstract] Objective To discuss the analgesic effect at the time of body position display of patients with fracture of lower limb before intraspinal anesthesia by the application of dezocine. Methods 60 cases of patients with fracture of lower limb treated from June 2014 to June 2015 were selected and were given intravertebral anesthesia and randomly divided into two groups with 30 cases in each， the test group were treated with dezocine intramuscular injection and the control group were treated with sodium chloride injection at the 15th minutes before the body position display of intravertebral anesthesia， the number sedation scores （NSS）at the time of quiet horizontal position （T1）and body position display （T2）and after successful combined spinal and epidural analgesia（T3）and VAS score changes of the two groups were compared. Results The difference in the VAS score between T1 and T2 was not obvious in the test group， in the control group， the VAS score at T2 was higher than that at T1， P<0.05， the VAS score at T2 in the test group was lower than that in the control group， P<0.05， the difference in the incidence between the test group and the control group was obvious （3.33% vs 16.67%），（χ2=4.396，P<0.05）. Conclusion Dezocine in the application of patients with fracture of lower limb before intraspinal anesthesia can relieve the pains at the time of body position display with few complications， which is worth promotion.

[Key words] Dezocine； Fracture of lower limb； Intraspinal anesthesia

地佐辛属于强效的阿片类镇痛药物，是苯吗啡烷类衍生物，在镇痛强度及作用时间等方面和吗啡相当，且不良反应小[1]。相关研究表明[2]，地佐辛应用效果较高，呼吸抑制等不良反应少，临床上应用广泛。为探析地佐辛用于下肢骨折患者椎管内麻醉前体位摆放时的镇痛效果，该研究随机选取2014年6月—2015年6月收治的60例下肢骨折患者作为研究对象，现报道如下。

1 资料与方法

1.1 一般资料

随机选取该院2014年6月—2015年6月收治的60例下肢骨折患者，行椎管内麻醉，ASAI-II级，入选标准：无椎管内麻醉禁忌症；无慢性疼痛病史；无严重心肾肝功能障碍，患者知情同意等。将其随机分为试验组和对照组，试验组：男性16例，女性14例，年龄26～68岁，平均（45.3±6.4）岁，体重55～71 kg，平均（68.5±6.4）kg，股骨干骨折10例，胫腓骨骨折8例，髌骨骨折8例，股骨颈骨折4例；对照组：男性15例，女性15例，年龄25～69岁，平均（45.7±6.2）岁，体重56～70 kg，平均（68.7±5.9）kg，股骨干骨折9例，胫腓骨骨折9例，髌骨骨折9例，股骨颈骨折3例；……