Clinical effect of patient controlled intravenous analgesia with different dose of dezocine and fentanyl on stress re-sponse post vertebral operation

ZUO Ling; LV Yanxia; LIU Chunsheng; LI Xiaohong; LI Xinjin

doi:10.3969/j.issn.1671-6450.2015.06.018

Abstract：Objective To observe the compatibility of different dose dezocine and fentanyl for lumbar surgery patient controlled intravenous analgesia ( PCIA) on stress response effect.Methods Under general anesthesia lumbar spinal surgery patients of 200 cases, 124 cases were male, 76 cases were female, age 35-50 years old, the body weight was 60-70 kg, ASA I-II, they were randomly divided to 5 groups, 40 cases in each group.Each group of PCIA drug preparation: fentanyl group (F Group) for fentanyl 18 g /kg, compatibility 1 (DF1) group dezocine 0.3 mg /kg +fentanyl 12 g /kg, compati-bility 2 (DF2) group dezocine 0.45 mg /kg +fentanyl 9 g /kg, compatibility 3 (DF3) group for dezocine 0.6 mg /kg +fentanyl 6 u g /kg.( D) dezocine group dezocine 0.9 mg /kg, each pump was added to ondansetron Joan 8 mg and normal saline were prepared into 100 ml, each background infusion rate was 2 ml /h.After 2, 6, 12, 24 and 48 h, using visual ana-logue scale (VAS) to evaluate the effect of analgesia, and after entering the operation room 10 min after operation and 2, 6, 24 h collected venous blood determination of blood glucose ( Glu) and plasma cortisol ( Cor) , epinephrine ( E) and the con-centration of norepinephrine (NE).Results Compared with F, D group, DF1, DF2, DF3 group after 2, 6, 12 h and 24 h, VAS score and 2, 6, and 24 h after operation’ s Glu, plasma Cor, E and NE concentration were decreased ( P <0.05 or 0.01);and compared DF1 and DF3 group, DF2 group after 2, 6, 12, and 24 h, VAS rating and 2, 6 and 24 h after opera-tion’s Glu, plasma Cor, E and NE concentration were decreased ( P <0.05 or 0.01).Conclusion Dezocine and fentanyl different doses combined with PCIA’ s analgesia effect and reduce postoperative stress reaction were better than the two sepa-rate application, and DF2 group’ s stress response are the lowest.