Effects Of Background Infusion On Intravenous Patient-controlled Analgesia With Dezocine Plus Flurbiprofen Axetil

Part ? Effects of postoperative PCIA with different doses background infusion of dezocine plus flurbiprofen axetil injection in patients undergoing colorectal operationObjective To compare the effectiveness of patient-controlled intravenous analgesia with different doses background infusion of dezocine plus flurbiprofen axetil injection in patients undergoing colorectal operation.Methods Eighty-seven patients scheduled for colorectal surgery,51 males and 36 females,aged 18-65 years,ASA physical status ? or ?,were randomly divided into 3 groups: common-dose background infusion group(Group CB,n=29),low-dose background infusion group(Group LB,n=29)and no background infusion group(Group NB,n=29).All patients were intravenously administered a PCA pump containing dezocine 0.6 mg/kg,flurbiprofen axetil 3 mg/kg and normal saline in a volume of 120 ml.Patients in Group CB were given background infusion rate 2 ml/h with PCA bolus dose 2 ml,patients in Group LB were given background infusion rate 1 ml/h with PCA bolus dose 2 ml,patients in Group NB were given PCA bolus dose 2 ml only.The consumption of analgesics and the pressing times of PCA were recorded at 24 and 48 h postoperatively.NRS scores,Ramsay sedation scores were recorded at 2,4,8,24 and 48 h after the operation.Rescue analgesics and rescue times,patients' satisfaction score and incidence of adverse reactions were recorded at 48 h after the operation.The time of first exhaust and the time of first leaving bed were recorded.Multiple linear regression analysis was used to analyze the influence factors of the time of first exhaust and the time of first leaving bed.Results At 24 and 48 h after the operation,the consumption of analgesics in Group CB were significantly higher than those in Group LB and Group NB(P<0.05).The effective and total pressing times of PCA at 24 and 48 h after the operation in Group CB were significantly lower than those in Group LB and Group NB(P<0.05),those in Group LB were significantly lower than those in Group NB(P<0.05).At 8,24 and 48 h postoperatively,the NRS scores at rest in Group NB were significantly higher than those in Group CB(P<0.05);At 8 and 24 h postoperatively,the NRS scores at rest in Group NB were significantly higher than those in Group LB(P<0.05);At 4,8,24 and 48 h postoperatively,the NRS scores during movement in Group NB were significantly higher than those in Group CB(P<0.05);At 8,24 and 48 h postoperatively,the NRS scores during movement in Group NB were significantly higher than those in Group LB(P<0.05);There is no statistical difference between Group LB and Group CB in NRS scores(P>0.05).At 24 h after the surgery,the Ramsay sedation scores in Group NB(Ramsay scores < 2)were significantly lower than those in Group LB and Group CB(P<0.05).The times of using supplementary analgesics in Group NB was significantly higher than those in Group CB and Group LB(P<0.05).The satisfaction scores in Group NB was significantly lower than that in Group CB and Group LB(P<0.05).The total incidence of adverse reactions in Group CB was significantly higher than those in Group LB and Group NB(P<0.05).Moreover,the time of first leaving bed in Group NB was significantly longer than those in Group CB and Group LB(P<0.05),and the time of first exhaust in Group LB was significantly shorter than those in Group CB and Group NB(P<0.05).The main influence factors of the time of first leaving bed were NRS score during movement at 24 h after the operation and gender(P<0.05).The main influence factors of the time of first exhaust were the time of first leaving bed,consumption of analgesics at 48 h after the operation and BMI(P<0.05).Conclusion Postoperative patient-controlled intravenous analgesia with low-dose background infusion of dezocine and flurbiprofen axetil injection(dezocine 0.005mg/(kg·h),flurbiprofen axetil 0.025mg/(kg·h))was more efficacious and satisfactory,with lower analgesic consumption,and can shorten recovery time after operation.Part ? Comparision of PCIA regimens with and without background infusion in patients undergoing laparoscopic colorectal cancer operation.Objective To compare the effectiveness of patient-controlled intravenous analgesia with or without background infusion of dezocine plus flurbiprofen axetil injection in patients undergoing laparoscopic colorectal cancer operation.Methods Sixty patients scheduled for laparoscopic colorectal cancer surgery,35 males and 25 females,aged 18-65 years,ASA physical status ? or ?,were randomly divided into 2 groups: common-dose background infusion group(Group CB,n=30),and no background infusion group(Group NB',n=30).All patients were intravenously administered a PCA pump containing dezocine 0.6 mg/kg,flurbiprofen axetil 3 mg/kg and normal saline in a volume of 120 ml.Patients in Group CB were given background infusion rate 2 ml/h with PCA bolus dose 2 ml,and patients in Group NB' were given PCA bolus dose 4 ml only.consumption of analgesic,NRS scores,Ramsay sedation scores,pressing times of PCA,supplementary analgesics,incidence of adverse reactions,time of first leaving bed,time of first exhaust and patients' satisfaction scores were recorded after surgery.Results Compared with Group CB,the consumption of analgesic in Group NB' were lower(P<0.05)At 24 and 48 h postoperatively,the NRS scores both at rest and during movement in Group NB' were higher at 4,8,24 and 48 h after surgery(P<0.05),the Ramsay sedation scores in Group NB' were lower at 24 and 48 h after operation(P<0.05).At 24 and 48 h postoperatively,the effective and total pressing times of PCA in Group NB' were higher(P<0.05).The incidence of using supplementary analgesics was higher(P<0.05).There is no statistical difference on the incidence of adverse reactions among the two groups(P>0.05).Moreover,the time of first leaving bed in Group NB' was longer than that in Group CB(P<0.05).The satisfaction scores in Group NB' was lower than that in Group CB(P<0.05).Conclusion Postoperative patient-controlled intravenous analgesia of dezocine and flurbiprofen with background infusion regimen was more efficacious and satisfactory,and more suitable in postoperative pain management in patients undergoing colorectal cancer surgery.