Application Of Dezocine For Preemptive Analgesia In Patients Undergoing Laparoscopic Radical Colorectal Surgery

Objective:To evaluate the efficacy of dezocine for preemptive analgesia in patients undergoing laparoscopic radical colorectal surgery.Methods:Fifty patients who undergoing laparoscopic radical colorectal surgery in the First Affiliated Hospital of Guangxi Medical University were randomly divided into two groups（n=25）:dezocine group（0.1mg/kg dezocine was intravenously injected 15 min before surgical）and control group（no making processing）.MAP,HR and blood glucose of the two groups of patients were observed recorded in room（T₀）,before skin resection（T₁）,10 min after pneumoperitoneum（T₂）and the end of operation（T₃）.The use of propofol,remifentanil and vasoactive drugs on intraoperative were recorded.Tracheal catheter removal time and PACU residence time were recorded.The patients’pain was evaluated by VAS score at 3 hours,6 hours,12 hours,and 24 hours after surgery.Rescued analgesics use during PACU stay,cumulative PCA consumption at 24 hours postoperative and rescued analgesics use in ward were record.CRP and WBC were recorded at one day before operation,one day after operation,3 days after operation and 5 days after operation.Postoperative adverse reactions of patients were recorded.Results:（1）The MAP of patients in the dezocine group at T₂was lower than that of the control group（P<0.05）,while there was no statistically significant difference between two groups on MAP at T₀,T₁and T₃time points（P>0.05）.HR of the two groups had no significant difference at each time point（P>0.05）.（2）The blood glucose of patients in the dezocine group at T₃was lower than that of the control group（P<0.05）.There was not statistically significant difference between two groups in blood glucose at T₀and T₁（P>0.05）.Compared with T₀in each group,there was no statistically significant difference in blood glucose level between the T₂and T₀in the dezocine group（P>0.05）,while the levels of T₂,T₃and T₀in the control group were all increased（P<0.05）.（3）Amount of propofol and vasoactive drugs in the two groups were not statistically significant（P>0.05）.However,the amount of remifentanil in the dezocine group was lower than that in the control group（P<0.05）.（4）There was no significant difference between two groups in the time of tracheal catheter removal time and the PACU residence time（P>0.05）.（5）VAS scores of the patients in the dezocine group at 3hours and 6 hours after surgery were statistically lower than those in the control group（P<0.05）,however,there was no significant differences between two groups at 12 hours and 24 hours after surgery（P>0.05）.（6）The number of rescuing analgesics use during PACU stay,cumulative PCA consumption and rescue analgesics use in ward within 24 hours in the dezocine group were all less than those in the control group（P>0.05）.（7）There was no significant difference in serum of CRP and WBC between two groups before operation（P>0.05）.The CRP of patients in two groups on one day,3 days and 5 days after the operation were higher than one day before the operation（P<0.05）,and reached a peak on the three days after operation.There was no statistical significance in the comparison of CRP between two groups on 1 day and 3 days after operation（P>0.05）,while the dezocine group was lower than the control group on 5 days after operation（P<0.05）.（8）There was no significant difference in serum WBC between two groups at each time point（P>0.05）.It was shown an upward trend in WBC on both groups,with the peak on 1 day after the operation.In the dezocine group,it was shown an increasing trend on 1 day and 3 days after surgery compared with the 1 day before operation（P<0.05）,and the level of 5days after operation was the same as that before one（P>0.05）.In the control group,the WBC on 1 day,3 days and 5 days after operation was higher than that on one day before surgery（P<0.05）.（9）There was no significant difference in adverse reactions such as nausea and vomiting,dizziness and respiratory depression between two groups（P>0.05）.Conclusion:The application of dezocine for preemptive analgesia in laparoscopic colorectal surgery can reduce the amount of analgesics used on intraoperative and postoperative and relieve postoperative pain of patients.There are no adverse side effects with a dose of 0.1 mg/kg dezocine at preoperative.