Effects of dezocine combined with fentanyl in patient-controlled intravenous analgesia after lumbar internal fixation

Objective To evaluate the effects of patient-controlled intravenous analgesia(PCIA) with dezocine and fentanyl after lumbar spine fixation.Methods Ninety patients with American Society of Anesthesiologists(ASA) Ⅰ-Ⅱ were scheduled for lumbar internal fixation and randomly divided into dezocine group(D),fentanyl group(F),and dezocine combined with fentanyl group(DF).There were 30 patients in each group.Intravenous anesthesia with tracheal intubation and PCIA were performed in all the patients.PCIA ingredients were as follows:in group D,dezocine 0.8 mg/kg with 0.9% normal saline diluted to 100 mL;in group F,fentanyl 16 μg/kg with 0.9% normal saline diluted to 100 mL;and in group DF,dezocine 0.4 mg/kg+fentany 8 μg/kg with 0.9% normal saline diluted to 100 mL.Visual analogue scale(VAS) and Ramsay scores were recorded 3,6,12,24 and 48 h postoperatively.The total press times and the effective times of PCIA,fentanyl consumption,adverse reactions,and patients' satisfaction were evaluated within 48 h after surgery.Results The heart rate(HR),blood pressure(BP) and pulse oxygen saturation(SpO2) in the three groups were in the normal range during PCIA.There was no significant difference in VAS score,Ramsay score,the total press times and the effective times at each time point in the three groups(P0.05).Compared with F group,DF group had less consumption of fentanyl at each time point(P0.01).The total incidence rates of adverse reactions in F group,D group and DF group were 53.3%,20%,and 6.7%,respectively.There were significant differences in the incidence rates between groups(P0.05 or P0.01).Patients' satisfaction in DF group was significantly higher than that in F group(90% vs.60%,P0.01).Conclusion PCIA with dezocine and fentanyl is an effective method for the postoperative analgesia in lumbar internal fixation.It can reduce the consumption of fentanyl and has high patient satisfaction and low incidence of adverse reactions.