Dose Of Dizocine For Postoperative Intravenous Analgesia In Patients Undergoing Vertebral Operation

Objectived: Postoperative pain is a common type of pain, it is found inalmost all patients after surgery. The postoperative of vertebral operationendure severe pain, which persists for at least3days. The pain brings themnor only the enormous physical and psychological suffering, it also led to aseries of multiple systems in patients with systemic change, and even inducedcardiovascular and cerebrovascular accidents; and the braking caused by fearof pain increased the incidence of postoperative complications, such asperoperative deep vein thrombosis, pulmonary infections, bed sores, etc. Itserious impact on pertoperative patient quality of life and body recovery.Therefore, a good postoperative analgesia is very important. Currently,fentanyl and sufentanil are the pprimary clinical analgesia drugs whichcommonly used in analgesia in the patients undergoing vertebral operation.But,the nausea, vomiting, respiratory depression, excessive sedation, andother adverse reactions limit the using in clinical. Dezocine is a new drug ofopioid agonists-antagonists. It mainly through activation κ recptors producesanalgesia, while it excited agonists-antagonists μ receptors. It make stronganalgesic effect, and is safety and well tolerated. Currently, the domesticresearch about dezocine used in patien controlled intravenous analgesia is less.This study is to assess the analgesic efficacy and side effect of dezocine forpostoperative Patient-controlled analgesia (PCIA) in the patients undergoingvertebral operation.Methods: Eighty ASA Ⅰo rⅡ patients aged30-65years weighing50-85kg undergoing vertebral operation under general anesthesia were randomlydivided into four groups: fentanyl0.125mg/ml (group A n=20), dezocine0.625mg/ml (group B n=20), dezocine0.5mg/ml (group C n=20), dezocine0.40mg/ml (group D n=20) were given intravenously after surgery with basal dose of2ml/h.Patient-controlled analgesia (PCA) demand dose of0.5ml andlockout interval of15min.The scores of pain, sedation were recorded at thetime points of4,8,16,24,48h. The side effects, nausea, vomiting,respiratory depression and titillation were also recorded.Results:1There was no signigicant difference among four groups on age, weight,sex, height, total rifentanil and propofol consumption.2During the48hours after operation, there was a satisfactory analgesiarate in each group, while the VAS scores in group D were significant higherthan other groups（P<0.05).3During the48hours after operation the sedation scores in group A weresignificant higher than other groups（P<0.05).4The vital signs were stable, there was no signigicant difference amongfour groups on HR,MVP and SPO2within48hours after surgery.5During the48hours after operation, the side effects in group A, B weresignificant higher than group D (P<0.05).6During the48hours after operation the number of PCA press in group Dwere significant higher than other groups（P<0.05).Conclusions:1Dezocine could be safely and effectively used in PCIA after vertebralsurgery.2The optimal PICA-dezocine0.5mg/mL; bolus:0.5ml; lockout time:15min provides best analgesia and suitable sedation without more incidence ofadverse reaction after vertebral surgery.