Comparation of dezocine and morphine for postoperative analgesia combined with Flurbiprofen after gynecological surgery
Xiaona Wang, Ling Yin, Hongwei Liu, Yonghao Yu
Abstract
Xiaona Wang, Ling Yin, Hongwei Liu, Yonghao Yu
Abstract
Objective To compare the efficiency and safety of dezocine and morphine combined with flurbiprofen for gynecologic postoperative analgesia.Methods Ninty patients for elective hysterectomy,ASA (American Society of Anesthesiologists) Ⅰ - Ⅱ,were randomly divided into three groups,given postoperative intravenous analgesic pump:dezocine 50 mg + flurbiprofen 100 mg( Group D) ;morphine 50 mg + flurbiprofen 100 mg ( Group M) ;dezocine 25 mg + morphine 25 mg + flurbiprofen 100 mg ( Group DM ).Anesthesia were induced by midazolam,etomidate,fentanyl and cisatracurium,maintained with propofol and remifentanil.At 15 -30 min before the end of surgery,flurbiprofen 50 mg was given,if pain was not relieved statsifically,morphine 5mg/per time was given additionally.VAS Pain relief scores,Ramsay sedation Score,usage of morphine and side effects such as nausea,vomiting and itch of skin were recorded at 4,8,24,48 h after surgery.Results At 4,8,24 and 48 h after surgery,VAS score at sedation was ( 2.27 ± 0.64 ),( 2.17 ± 0.65 ),( 1.97 ± 0.67 ),and ( 1.60 ± 0.56) in Group D,and ( 2.50 ± 0.63 ),( 2.40 ± 0.62),( 2.20 ± 0.61 ) and ( 1.87 ± 0.57 ) in Group DM at sedation,which were all significantly low than those of ( 3.10 ± 0.76),( 3.00 ± 0.74 ),( 2.80 ± 0.71 )and (2.40 ±0.72)in Group M.At 4,8,24 and 48 h after surgery,VAS score at active was (3.10 ±0.76),(2.97 ±0.76),(2.70 ±0.84) and (2.17 ±0.70)in Group D,(3.43 ±0.63),(3.30 ±0.65),(3.03 ±0.76)and (2.43 ± 0.68 )in Group DM,which were all significantly lower than those of (4.13 ± 0.94),(3.93 ±1.05),(3.60 ± 1.05 ) and ( 3.03 ± 0.96 ) in Group M ( Ps < 0.05).And the VAS scores of Group DM was significantly higher than those of Group D.Sedation score at 48 h after surgery in group D was better than that in Group M ( x2 =4.812,P < 0.05 ),The side effects at 48 h after surgery was 26.7% in Group D,46.7% in Group DM and 80% in Group M,and there significant difference among these 3 groups (P < 0.05 ).Conclusion Compared to Morphine and or Morphine combined with Dezocine,Dezocine 50 mg + flumazenil 100 mg group is better to release the postoperative pain,and withless adverse effects. Key words: Postoperative analgesia; Dezocine; Morphine; Hysterectomy
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Objective To compare the efficiency and safety of dezocine and morphine combined with flurbiprofen for gynecologic postoperative analgesia.Methods Ninty patients for elective hysterectomy,ASA (American Society of Anesthesiologists) Ⅰ - Ⅱ,were randomly divided into three groups,given postoperative intravenous analgesic pump:dezocine 50 mg + flurbiprofen 100 mg( Group D) ;morphine 50 mg + flurbiprofen 100 mg ( Group M) ;dezocine 25 mg + morphine 25 mg + flurbiprofen 100 mg ( Group DM ).Anesthesia were induced by midazolam,etomidate,fentanyl and cisatracurium,maintained with propofol and remifentanil.At 15 -30 min before the end of surgery,flurbiprofen 50 mg was given,if pain was not relieved statsifically,morphine 5mg/per time was given additionally.VAS Pain relief scores,Ramsay sedation Score,usage of morphine and side effects such as nausea,vomiting and itch of skin were recorded at 4,8,24,48 h after surgery.Results At 4,8,24 and 48 h after surgery,VAS score at sedation was ( 2.27 ± 0.64 ),( 2.17 ± 0.65 ),( 1.97 ± 0.67 ),and ( 1.60 ± 0.56) in Group D,and ( 2.50 ± 0.63 ),( 2.40 ± 0.62),( 2.20 ± 0.61 ) and ( 1.87 ± 0.57 ) in Group DM at sedation,which were all significantly low than those of ( 3.10 ± 0.76),( 3.00 ± 0.74 ),( 2.80 ± 0.71 )and (2.40 ±0.72)in Group M.At 4,8,24 and 48 h after surgery,VAS score at active was (3.10 ±0.76),(2.97 ±0.76),(2.70 ±0.84) and (2.17 ±0.70)in Group D,(3.43 ±0.63),(3.30 ±0.65),(3.03 ±0.76)and (2.43 ± 0.68 )in Group DM,which were all significantly lower than those of (4.13 ± 0.94),(3.93 ±1.05),(3.60 ± 1.05 ) and ( 3.03 ± 0.96 ) in Group M ( Ps < 0.05).And the VAS scores of Group DM was significantly higher than those of Group D.Sedation score at 48 h after surgery in group D was better than that in Group M ( x2 =4.812,P < 0.05 ),The side effects at 48 h after surgery was 26.7% in Group D,46.7% in Group DM and 80% in Group M,and there significant difference among these 3 groups (P < 0.05 ).Conclusion Compared to Morphine and or Morphine combined with Dezocine,Dezocine 50 mg + flumazenil 100 mg group is better to release the postoperative pain,and withless adverse effects. Key words: Postoperative analgesia; Dezocine; Morphine; Hysterectomy
Key concepts: Dezocine, Flurbiprofen, Medicine, Anesthesia, Midazolam, Butorphanol, Morphine, Fentanyl