Research On Postoperative PCIA Effect And Early Postoperative Cognitive Function Recovery Influence Of Using Dezocine Combined With Fentanil, Or With Sufentanil After Radical Operation For Carcinoma Of Stomach

Objective:To observe the postoperative PC IA effect and Early postoperative cognitive function recovery influence of using dezocine combined with fentanil, or with sufentanil, or only fentanil or sufentanil in patients underwent radical operation for carcinoma of stomach.Methods:80stomach cancer patients who are in ASA I～II level aged30--60ys; weighted40-85kg; with health body mass index; no medical history on hypertension/psychosis/neuropathy; no long-term sedative medicine taking; no alcoholism/drug dependency and no severe dysopia/auditory handicap) were randomly divided into4groups:groupDF/DS/F/S,20in each group. All patients were given general anesthetic, infused with10ml PCIA analgesics30mins before operation ends up, and were connected the analgesic pump after anesthesia awake.PCIA gradients:group DF:dezocine0.3mg/kg+fentanil0.015mg/kg+Ondansetron4mg+0.9%sodium chloride injection to100ml.group DS:dezocine0.3mg/kg+sufentanil1.5ug/kg+Ondansetron4mg+0.9%sodium chloride injection to100ml.Group F:fentanil0.03mg/kg+Ondansetron4mg+0.9%sodium chloride injection to100ml.Group S:sufentanil2ug/kg+Ondansetron4mg+0.9%sodium chloride injection to100ml.2ml/h PCIA background dose and15mins lock time for above gradients. Then observe and check VAS scores; Ramsay scores; adverse reactions and satisfaction degree in quiet of2,4,6,8,12,24,48hours after operation. We also take the MMSE assessment of patients at Id before operation and3h,12h,24h,24h after operation.Results:The results are unrelated with4groups’samples; age; height; weight and operation times.Group DS and S provided good analgesic effect. The VAS scores at all time spots are no difference between group F and group DF (P>0.05). There is also no difference between group DS and group S (P>0.05). The VAS scores at respective time spots after operation are significantly higher than group S and group DS (P=0.002). None of the groups showed Excessive sedation after postoperative PCIA. The Ramsay scores on respective time spots have no difference for group DF and group D(P>0.05). No difference about2h、4h、12h、48h post operation data between group S and group DS (P>0.05), but group S has obvious difference with others in6h,8h post operation data (P<0.05), group DF and group F have statistical difference with group DS and group S in2h、4h、6h、8h post operation data(P<0.05), there are no differences at time spots of12h、24h、48h for4groups(P>0.05). The MMSE scores about1d before operation for4groups have no statistical difference(P>0.05). The comparison within groups:The3d post operation MMSE scores for4groups have the statistical difference with MMSE scores in other time spots(P<0.05). For group DF, the scores of12h、24h、48h post operation have no difference with1d before operation(P>0.05). For group DS and group S,the MMSE scores at any spots post operation have the difference with scores at1d before operation(P<0.05). To compare with Group S/DS and Group F/DF, the MMSE scores at any time spots have the statistical difference (P<0.05).Group S showed more adverse reactions than others (P<0.05). There statistical difference demonstrated among4groups when compared in pair wise comparison (P<0.05). As for satisfaction, there are differences when group DS compares group DF/group F. But none between group DF and group F, group DS and group S(P>0.05). There are differences when group DS compares group DF and group F, the same when group S compares group DF and group F(P<0.05). Group DS has the highest satisfaction degree.Conclusion.-dezocine0.3mg/kg+sufentanil1.5ug/kg+Ondansetron4mg+0.9%sodium chloride injection to100ml. used in postoperative PCIA for radical operation for carcinoma of stomach showed better and safer analgesic effect, less adverse reactions and positive impact on Cognitive function recovery.