Efficacy and safety of dezocine after laparoscopic cholecystectomy at a high altitude area
10.3760/cma.j.issn.1008-5734.2019.05.009
- VernacularTitle:高海拔地区腹腔镜胆囊切除术后地佐辛镇痛的效果及安全性观察
- Author:
Zhicui ZHANG
1
;
Shihua WU
;
Ji ZHEN
Author Information
1. 北京双桥医院麻醉科 100024
- Publication Type:Journal Article
- Keywords:
Analgesics,opioid;
Sufentanil;
Pain,postoperative;
Analgesia;
Cholecystectomy,laparoscopic;
Altitude;
Dezocine
- From:
Adverse Drug Reactions Journal
2019;21(5):360-365
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the efficacy and safety of dezocine after laparoscopic cholecystectomy at a high altitude area (average altitude of over 4 500 m).Methods The study was designed as an open randomized controlled study.The subjects were selected from patients who underwent laparoscopic cholecystectomy and required postoperative analgesia in Duilongdeqing District People's Hospital of Lhasa.The patients were randomly divided into the observation group and the control group.They had the same anesthesia method during operation and patient-controlled intravenous analgesia (PCIA) was initiated after the operation.The patients in the observation group were treated with dezocine 0.6 mg/kg plus ondansetron 16 mg diluted in 0.9％ sodium chloride injection 100 ml for PCIA,while in the control group,dezocine was replaced by sufentanil 2 μg/kg.According to the difference in the incidence of excessive sedation between dezocine and sufentanil in previous literature,it was estimated that the sample size in the 2 groups should be ＞ 14 cases and the patients should be terminated when the test efficacy was ＞ 0.8.Visual analogue scale (VAS) score (pain evaluation) and Ramsay sedation scale (sedation evaluation) at 1,4,8,12,24 and 48 hours,frequency of PCIA pump pressing and dosage of anesthetics,and the incidence of adverse events related to analgesics within 48 hours after operation in patients in the 2 groups were compared.Results From January 2015 to November 2017,a total of 50 patients were enrolled in the study,including 25 in the observation group and 25 in the control group.The differences in gender,age,weight,American Society of Anesthesiologists classification,operation time,frequency of PCIA pump pressing and dosage of anesthetics between the 2 groups were not significant (P ＞ 0.05 for all).The differences in VAS scores at all time points after operation were not significant (P ＞ 0.05 for all).The Ramsay sedation scores in patients in the observation group at 1 and 4 hours after operation were significantly lower than those in the control group [(2.5±1.1) scorevs.(3.4±1.4) score,P=0.016;(2.5±1.0) scorevs.(3.5±1.5) score,P=0.007].The incidences of sedation-related adverse events such as nausea,vomiting,respiratory depression within 48 hours after operation in the control group were significantly lower than those in the control group [8.0％ (2/25)vs.36.0％ (9/25),0vs.24.0％ (6/25),4.0％ (1/25)vs.44.0％ (11/25),P＜0.05for all].Conclusions The analgesic effect of dezocine after laparoscopic cholecystectomy at high altitudes was similar to that of sufentanil and the incidences of respiratory depression and excessive sedation were lower than those of sufentanil.Dezocine may be safer for patients at high altitudes.
