Objective To assess the analgesic efficacy of patient controlled intravenous analgesia ( PCIA ) with dezocine combined with ketamine in postoperative analgesia for thoracic surgery patients .Methods 90 patients with thoracic surgery were randomly divided into the three group ,30 cases in each group,all the patients received PCIA after operation.PCIA formula:dezocine combined with ketamine group (group A),dezocine 0.4mg/kg+ket-amine 4mg/kg+ondansetron 8mg,diluted to 100mL by adding saline;dezocine group (group B),dezocine 0.6mg/kg+ondansetron 8mg,diluted to 100mL by adding saline;fentanyl group (group C),fentanyl 15μg/kg+ondansetron 8mg, diluted to 100mL by adding saline.VAS,Ramsay scores and side effects were recorded and compared at 2,4,8,12, 24,48h after the surgery.Results 4,8,12h after operation,the VAS score in group A and C was lower than that in group B (all P<0.05).4,8,12h after operation,the Ramsay score in group A was higher than that in group B and C (all P<0.05).The incidence rate of nausea,vomiting in group C was higher than that in group A and B (all P<0.05).Conclusion Dezocine combined with ketamine in PCIA for thoracic surgery patients exhibits exact analgesia effect with less side effects .

Objective To investigate the clinical application of dezocine and remifentanil in elderly patients with painless gastroscopy.Methods According to random number table,180 elderly patients undergoing painless gas-troscopy were randomly divided into dezocine group(group D),remifentanil group(group R)and control group(group C),each group 60 cases.Group D was infusion with dezocine 20μg/kg,Group R was infusion with remifentanil 0.5μg/kg and Group C was infused with normal saline,then three groups patients,respectively,after the interval of 1 minutes were given propofol 1 mg/kg.Objects induced sum of propofol,starting time,awakening time,discharged time,HR,MAP and SpO2 during operation,sedation scores,postoperative side effects such as nausea and vomiting were observed.Results The decrease of MAP was alleviated in group D compared with group C and group S(tDR =2.278,PDR<0.05 and tDC =2.545,PDC <0.05).SpO2 in group C and group R were significantly lower than that in group D(tDR=2.184,PDR<0.05 and tDC =2.206,PDC <0.05).The time for regaining consciousness(tDC =5.401 and tRC =6.674)and propofol dosage(tDC =3.726 and tRC=4.213)in group D and group R were significantly lower than those in group C(P<0.05).The Ramsay of group D was (2.3 ±0.7)points,which was lower than (3.8 ±1.2) points of group C,(3.6 ±0.9)points of group R(tDC =8.938,PDC <0.01;tDR=7.154,PDR<0.01),and there were fewer adverse reactions in group D.Conclusion Dezocine is more suitable for the elderly patients than remifentanil, which has exact effect of anesthesia,less respiratory depression,higher level of consciousness awakening and fewer adverse reactions.