目的 评价地佐辛配伍丙泊酚联合喉罩用于无痛纤维支气管镜检查的效果。 方法 将2012年10月－12月拟行纤维支气管镜检查，且按美国麻醉医师协会分级Ⅰ或Ⅱ级的60例患者，随机分为芬太尼组（F组）、地佐辛组（D组）、生理盐水组（N组）,每组20例。采用双盲法给药，静脉注射芬太尼（10 μg/mL）或地佐辛（1 mg/mL）或生理盐水0.1 mL/kg，5 min后3组缓慢静脉注射丙泊酚2 mg/kg诱导后置入喉罩，术中保留自主呼吸，持续泵入丙泊酚4～6 mg/（kg·h）维持麻醉，观察3组患者诱导前（T0）、诱导后时（T1）、纤维支气管镜操作时（T2）、术毕时（T3）及拔除喉罩时（T4）的生命体征，记录丙泊酚总用量、苏醒时间、苏醒时的呼吸道疼痛视觉模拟评分（VAS），记录术中及术后有关并发症的发生情况。 结果 与N组相比，D、F两组丙泊酚总用量减少、苏醒时间缩短，头昏及术中体动发生率、VAS评分明显降低（P＜0.05）；呼吸暂停的发生率D组最低（P＜0.05）；恶心、呕吐的发生率F组最高（P＜0.05）。 结论 地佐辛配伍丙泊酚联合喉罩用于无痛纤维支气管镜检查，麻醉效果满意，术后镇痛效果好，值得临床推广。
目的 研究地佐辛＋咪达唑仑在大隐静脉射频闭合术中的镇静作用，并观察其对生命体征的影响以及不良反应的发生情况。方法 选取60例行大隐静脉射频闭合术患者，根据麻醉方式分为芬太尼＋咪达唑仑组和地佐辛＋咪达唑仑组２组，每组30例。分别监测心率（HR）、动脉血氧饱和度（SpO2）、平均动脉压（MAP），记录用药后5min和30min的镇静评分、生命体征以及术中不良反应的发生情况。结果 给药后5min和30min的镇静效果评分芬太尼＋咪达唑仑组分别为（2.95±0.14）分和（4.09±0.05）分，地佐辛＋咪达唑仑组分别为（3.16±0.09）分和（4.08±0.08）分，2组比较差异无统计学意义（P＞0.05）。2组给药后5min和30min的HR、SpO2及MAP比较差异均无统计学意义（P＞0.05）；与给药前（0min）比较，差异也无统计学意义（P＞0.05）。2组患者镇静良好，无躁动，均无一例发生呼吸抑制，仅芬太尼＋咪达唑仑组有4例发生呛咳。结论 芬太尼和地佐辛联合咪达唑仑用于大隐静脉射频消融手术患者，镇静效果良好，对生命体征影响小，但地佐辛组无呛咳，不良反应发生率更低。
ObjectiveTo observe the efficacy of dezocine used for atrial fibrillation radiofrequency catheter ablation. MethodsForty-five patients who would undergo radiofrequency catheter ablation of atrial fibrillation were randomly chosen to be our study subjects between April and July 2013. According to the randomized and double-blind principle, they were divided into group D (dezocine group) and group M (morphine group). During routine visits prior to surgery, we recorded the patients' vital signs, pain score and degree of comfort. Before the ablation procedure, 5 mg dezocine or 5 mg morphine was administered intravenously for patients in both the two groups. During the procedure, blood pressure, heart rate, oxygen saturation, electrocardiogram, pain scores, and comfort score of the patients were monitored. Furthermore, 2-3 mg dezocine or morphine were administered intravenously if additional analgesia was needed. The time of the procedure was recorded. The patients were followed up and evaluated 2, 6 h and 24 hours after the procedure. ResultsThe procedure time, pain rating index, and visual analogue scores were significantly different between the two groups (P < 0.05). Adverse reaction during or after the procedure was not significantly different (P > 0.05). ConclusionsThe analgesic effect of dezocine is better than morphine for atrial fibrillation radiofrequency catheter ablation. The incidence of adverse reactions such as nausea and vomiting is still high. Dezocine for analgesia in atrial fibrillation ablation can be used as an ideal alternative instead of general anesthesia.
ObjectiveTo evaluate the efficacy and safety of dexmedetomidine combined with dezocine for patient-controlled intravenous analgesia (PCIA) in patients after radical operation for abdominal tumor. MethodsBetween September 2012 and May 2013, 60 patients (aged 40-60, American Sociaty of Anesthesiologists physical statusⅠ-Ⅱ) undergoing abdominal tumor surgery and asking for PCIA pumps voluntarily were randomly divided into two groups (group D and group DF) with 30 in each group. Patients in group D were given sufentanil 0.25 μg/kg+ dezocine 0.4 mg/kg, which were added into 100 mL 0.9% normal saline, while in group DF, the patients received dexmedetomidine 1.5 μg/kg+ sufentanil 0.15 μg/kg+ dezocine 0.4 mg/kg, which were added into 100 mL 0.9% normal saline. The changes of mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), the visual analog scale (VAS), Ramsay sedation scale, Bruggrmann analgesia scale (BCS), the efficacy of postoperative analgesia and adverse effects were observed and recorded at the preoperative time (T0), and 2 (T1), 4 (T2), 8 (T3), 24 (T4) and 48 hours (T5) postoperatively. ResultsHemodynamics in group DF was more stable than that in group D (P<0.05). There were no statically significant differences in terms of VAS and BCS between the two groups at each time point (P>0.05). The Ramsay sedation scale of group DF was better than group D, and the difference was statistically significant (P<0.05). The efficient number of pressing within 48 hours in the two groups was not significantly different (P>0.05). The incidence of nausea, vomiting and drowsiness in group D was more than that of group DF (P<0.05). ConclusionDexmedetomidine combined with dezocine can provide effective postoperative analgesia with less adverse effects for patients after radical surgery of abdominal tumor, which provides higher satisfaction to the abdominal surgery patients.
ObjectiveTo systematically evaluate the effectiveness and safety of dezocine versus fentanyl for postoperative patient-controlled intravenous analgesia (PCIA). MethodsWe electronically searched the specialized trials registered in The Cochrane Library (Issue 2, 2013), the Cochrane anesthesia group, MEDLINE, EMbase, CBM, CNKI, VIP and WanFang Data from inception to February, 2013. Randomized controlled trials (RCTs) on dezocine versus Fentanyl for postoperative PCIA were included. RevMan 5.0 software was used for meta-analysis after critically literature screening, data extracting and assessing of methodological quality independently by two reviewers. ResultsA total of 15 RCTs involving 1 116 patients were finally included. The results of meta-analysis showed that there was no significant difference in postoperative analgesia and sedation at the hour-points of 2 h, 4 h, 6 h, 8 h, 12 h, 24 h, and 48 h after surgery. As for safety, the incidences of postoperative nausea, vomiting, skin pruritus, respiratory depression and uroschesis in the dezocine group were lower than those in the fentanyl group. ConclusionCompared with fentanyl, dezocine has the same effects of analgesia and sedation for PCIA; its incidence of adverse reactions is lower, so dezocine is safer in clinic.
ObjectiveTo systematically assess the effectiveness and safety of I.V. infusion of dezocine for prevention of myoclonus caused by etomidate. MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 6, 2014), CNKI, WanFang Data and VIP were electronically searched from inception to May 2014 for randomized controlled trials (RCTs) on I.V. infusion of dezocine for prevention of myoclonus caused by etomidate. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2.3 software. ResultsTen RCTs were included. The results of meta-analysis indicated that, dezocine could reduce the incidence of myoclonus induced by etomidate (RR=0.24，95%CI 0.12 to 0.45, P<0.000 1), and was better than fentanyl (RR=0.30, 95%CI 0.17 to 0.51, P<0.000 1); dezocine could reduce the amount of etomidate (MD=-4.70, 95%CI -6.62 to -2.79, P<0.000 01); compared with fentanyl, dezocine could reduce the incidence of injection pain (OR=0.25, 95%CI 0.10 to 0.62, P=0.003); dezocine did not increase the incidence of respiratory depression (OR=2.61, 95%CI 0.12 to 56.03, P=0.54). ConclusionI.V. infusion of dezocine before etomidate administration could reduce myoclonus incidence caused by etomidate, reduce the amount of etomidate, and is better than fentanyl; which could also reduce the incidence of injection pain, and not increase the incidence of respiratory depression.
Objective To clearly define and describe the difference of analgesic actions and side effects between dezocine and parecoxib sodium in video-assisted thoracic surgery (VATS) lobectomy. Methods Ninety patients underwent thoracotomy (lobectomy) and were hospitalized in the Department of Thoracic Surgery, West China Hospital, Sichuan University between August 2015 and January 2016. Patients were randomly divided into two groups including a parecoxib sodium group (a PG group, 43 patients) and a dezocine group (a DG group, 47 patients). We analyzed the occurrence of side effects in the two groups, as well as other outcomes including visual analogous scores and location of the pain et al. Results The occurrences of nausea, vomit and abdominal distention in the PG group (9.30%, 2.33%, 13.95%) were significantly lower than those of the DG group (25.53%, 17.02%, 40.43% , P=0.046, P=0.032, P=0.009) in the early period after operation. Pain scores at the postoperative 12 h, 24 h, 48 h and 72 h in the PG group (2.56±0.96, 2.47±0.96, 1.93±0.99, 0.98±1.24) were better than those of the DG group (4.00±1.60, 3.62±1.48, 3.36±1.55, 2.47±1.78,P=0.000, P=0.000, P=0.000, P=0.002). And the same results were found in the postoperative coughing VAS assessment. The mostly reported pain location was the chest drainage, incision site and chest wall in turn. Postoperative pain properties, in turn, were swelling, stabbing pain and numbness. Conclusion Postoperative pain after VATS lobectomy may be adequately controlled using parecoxib sodium. The low pain scores and decreased adverse effects are achieved.
ObjectivesTo systematically evaluate the efficacy and safety of dezocine combine with sufentanil (DS) versus sufentanil (S) for postoperative analgesia.MethodsCNKI, WanFang Data, VIP, PubMed, Wiley Online Library and ScienceDirect databases were searched online to collect randomized controlled trials (RCTs) of DS versus S for postoperative analgesia from January 2011 to July 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata13.0 software.ResultsA total of 39 RCTs were included. The results of meta-analysis showed that: DS group had higher scores on VAS at 2 h, 6 h, 12 h, 24 h and 48 h points than S group at the dezocine level of 0.2 mg/kg. At the dezocine level of 0.3 mg/kg, there were no significant differences in scores on VAS at 2 h and 4 h. However, DS group had higher scores at 6 h, 12 h, 24 h and 48 h points. At the dezocine level of 10 mg/kg, there were no significant differences in scores on VAS at each time point in both groups. DS group was superior to S group in " excellent rate” and " good rate” of the analgesic satisfaction of patients. For safety, the incidence of postoperative nausea and vomiting of DS group was lower than S group.ConclusionsThe current evidence shows that dezocine combine with sufentanil have more effects of postoperative analgesia than sufentanil alone, and its incidence of adverse reactions is lower. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusions.