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Objective To compare the analgesic effect and adverse event of butorphanol and dezocine which are combined with sufentanil and flurbiprofen axetil in PCIA,to screen out a relatively good analgesic.Methods 110 laparotomy cases from hepato-pancreato-biliary (HPB) department and 160 laparoscopy cases from general surgery(GS) department of xinqiao hospital of third medical university were included in our study.All patients were randomly divided into two groups according to the random number table method,namely the butorphanol group and dezocine group.Butorphanol 0.04 mg/kg,sufentanil 2.8 μg/kg,flurbiprofen axetil 3 mg/kg and granisetron 6 mg were used in HPB butorphanol group.Dezocine 0.2 mg/kg,sufentanil 2.8 μg/kg,flurbiprofen axetil 3 mg/kg and granisetron 6 mg were used in HPB dezocine group.Butorphanol 0.04 mg/kg sufentanil 2.5 μg/kg,flurbiprofen axetil 3 mg/kg and granisetron 6 mg was used in GS butorphanol group.Dezocine 0.2 mg/kg,sufentanil 2.5 μg/kg,flurbiprofen axetil 3 mg/kg and granisetron 6 mg was used in GS dezocine group.The mean arterial pressure(MAP),heart rate(HR),facial expressions of pain score,sedation score,PONV score,NRS score and respiratory depression were observed in postoperative 0 hour,6 hours,24 hours,48 hours.Results For both two departments,the numbers of patients with NRS score and facial expressions of pain scores greater than 3 in dezocine group were more than those in butorphanol group,the differences were significant(P ＜ 0.05).There was no statistically significant difference in numbers of patients with NRS score and facial expressions scale of 1 to 3 (P ＞ 0.05).while the number of cases with sedation score ranged from 1 to 3 in dezocine group was less than that in both HPB and GS butorphanol group(P ＜ 0.05).There was no statistically significant difference in PONV score and itching score which was or less than 3 or more than 3 (P ＞ 0.05).Conclusion For postoperative analgesia in PCIA,butorphanol has better analgesic effect than the same dose of dezocine,and stronger sedation effect than dezocine.
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Objective To evaluate the efficacy and safety of domestic palonosetron hydrochlo-ride injection on its prevention of postoperative nausea and vomiting.Methods A multi-centered,ran-domized,double-blinded and placebo-controlled clinical trial was carried out.A total of 281 patients were enrolled,with 141 of patients in study group and 140 of patients in control group respectively. 0.075 mg of intravenous palonosetron hydrochloride injection was delivered in the study group before anesthesia induction.The drug was substituted by 1.5 ml of NS in the control group.All anesthesia inductions were conducted by the intravenous injection of propofol,fentanyl and rocuronium,and were maintained with sevoflurane and fentanyl.Complete remission rate and treatment failure cut-off time of vomiting were evaluated at 0-6 h,6-72 h,0-72 h postoperatively.Results In the study group CR% 0-6 h,6-72 h and 0-72 h were 107 (75.89%),104 (73.76%)and 92 (65.25%),the control group was 81 (57.86%),70 (50%)and 62 (42.86%),CR% of the study group was significantly higher than that of the control group (P <0.01).Insignificant statistical difference but significant clin-ical difference exists in their treatment failure cut-off time,386.5 min and 300.0 min,respectively be-tween the groups.Conclusion Domestic palonosetron hydrochloride injection is safe and effective in the prevention of postoperative nausea and vomiting.
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Objective To explore the antiemetic mechanism of propofol in patients subjected to laparoscopic cholecystectomy under general anesthesia Methods Sixty ASA Ⅰ Ⅱ patients of either sex undergoing elective laporoscopic cholecystectomy were randomly assigned to three groups : control group (group C), ondansetron group (group O) and propofol group(group P) Anesthesia was induced with thiopental 5 7 mg?kg -1 and intubation was facilitated with succinylcholine 1 1.5mg?kg -1 In group C and O anesthesia was maintained with inhalation of 1 0% 1 5% isoflurane and intermittent bolus of vecuronium In group O ondansetron 4 mg was given intravenously before induction of anesthesia In group P anesthesia was maintained with continuous intravenous infusion of 1% propofol at a rate of 50 150 ?g?kg -1 ?min -1 and intermittent bolus of vecuronium At the end of operation neostigmine 1mg and atropine 0 5 mg were regularly given to antagonize the residual neuromuscular blockade Venous blood samples were taken before anesthesia (baseline), after intubation, at the end of operation and 6h after operation for determination of plasma motilin(MTL) level Postoperative nausea and vomiting (PONV) was assessed according to WHO standard in four grades from no nausea to severe vomiting with gastric content Results In group C the plasma MTL level at the end of operation was significantly higher than that before anesthesia (P