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| Effects of intravenous injection of Dezocine on the pain threshold, spontaneous breathing and consciousness in patients |
| HAO Dandan MU Feng WANG Baoguo WANG Shuangyan |
| Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China |
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Abstract Objective To investigate the effects of intravenous injection of Dezocine on the pain threshold, spontaneous breathing and consciousness in patients. Methods Eighty patients [18-60 years of age, 18-25 kg/m2 of body mass index (BMI), American Society of Anesthesiologists (ASA) class Ⅰ-Ⅱ] undergoing selective surgery in Sanbao Brain Hospital, Capital Medical University from April to November 2017 were divided into four groups according to the random number table method (n = 20). Before anesthesia, the patients were intravenously injected Dezocine 5 mg in group D1, Dezocine 10 mg in group D2, Fentanyl 0.1 mg in group F and equivalent normal saline in group NS. The respiratory rate per minute (RR), partial pressure of carbon dioxide in endexpiratory gas (PETCO2), oxygen saturation (SpO2), heart rate (HR), mean arterial pressure (MAP), observer′s assessment of alertness and sedation (OAA/S) score, pain and pain tolerance thresholds of patients for 2 Hz/100 Hz electrical stimulation were recorded before injection (T0) and at 5 min (T1), 10 min (T2), 15 min (T3) after injection. Dizziness, somnolence, respiratory depression and other adverse reactions were observed as well. Results Pain thresholds and pain tolerance thresholds at T1-T3 in four groups were significantly higher than those at T0 (P ＜ 0.05); compared with group NS, pain thresholds at T2-T3 in group D1, pain thresholds at T1-T3 and pain tolerance thresholds at T2-T3 in group D2, pain thresholds and pain tolerance thresholds at T1-T3 in group F were increased (P ＜ 0.05). RR and SpO2 at T1-T3 in group D2 and group F were dramatically decreased than those at T0, PETCO2 at T1-T2 in group D2 and at T1-T3 in group F increased than those at T0, the differences were statistically significant (P ＜ 0.05); compared with group NS, RR and SpO2 at T1-T3 in group F decreased significantly, while PETCO2 increased significantly, the differences were statistically significant (P ＜ 0.05); compared with group F, RR and SpO2 at T1-T3 in group D1 increased significantly, while PETCO2 decreased significantly, the differences were statistically significant (P ＜ 0.05). Moreover, the number of cases of decreased OAA/S score at T1-T2, the incidence of somnolence and respiratory depressionin in group F, and the incidence of respiratory depression in group D2 were higher than those in group NS (P ＜ 0.05). Conclusion Compared with Fentanyl 0.1 mg, the treatment of intravenous injection with Dezocine 10 mg can get comparative analgesic effect, while the analgesic effect of Dezocine 5 mg is slightly less than that of Fentanyl 0.1 mg. The intravenous injection of Dezocine 5 mg is safe and effective. However, when its dose increases to 10 mg, a short period of respiratory depression (≤10 min) can be seen, indicating that we should pay attention to the change of spontaneous breathing in case of related complications.
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[1] Imam MZ，Kuo A，Ghassabian S，et al. Progress in understanding mechanisms of opioid-induced gastrointestinal adverse effects and respiratory depression [J]. Neuropharmacology，2018，131（12）：238-255.
[2] 刘教，刘真，赵晶.阿片类药物呼吸抑制作用的机制研究进展[J].基础医学与临床，2017，37（3）：422-466.
[3] Zhou X，Zhang C，Wang M，et al. Dezocine for Preventing Postoperative Pain：A Meta-Analysis of Randomized Controlled Trials [J]. PLoS One，2015，10（8）：1-15.
[4] Yao ZY，Jia Z，Xie YH，et al. Analgesic effect of dezocine in different doses on elderly patients undergoing abdominal operation under general anesthesia and its influence on stress response to postoperative tracheal extubation [J]. Eur Rev Med Pharmacol Sci，2017，21（22）：5223-5229.
[5] Soleimani A，Kiabi FH，Habibi MR，et al. Intravenous dezocine for suppressin entanyl-induced cough during general anesthesia induction：A potentially effective and clinically feasible method [J]. J Anaesthesiol Clin Pharmacol，2017，33（4）：556-557.
[6] 岳修勤.地佐辛与芬太尼应用于术后静脉镇痛的临床效果比较[J].中国疼痛医学杂志，2010，6（4）：255.
[7] Gal TJ，DiFazio CA. Ventilatory and analgesic effects of dezocine in humans [J]. Anethesiology，1984，61（6）：716-722.
[8] Liu R，Huang X，Yeliseev A，et al. Novel molecular targets of dezocine and their clinical [J]. Anesthesiology，2014， 120（3）：714-723.
[9] Wu FX，Babazada H，Gao H，et al. Dezocine Alleviates Morphine-Induced Dependence in Rats [J]. Anesth Analg，2018doi：10.1213/ANE.000000000 0003365.
[10] Cieslinska A，Sienkiewicz-SzlaPka E，Kostyra E，et al. Mu-opioid receptor gene（OPRM）polymorphism in patients with breast cancer [J]. Tumour Biol，2015，36（6）：4655-4660.
[11] 毕海金，吴国程，陈红云，等.人体痛阈测定方法及其应用研究进展[J].中国疼痛医学杂志，2015，21（1）：60-63.
[12] Hsu YW，Somma J，Hung YC，et al. Predicting postoperative pain by preoperative pressure pain assessment [J]. Anesthesiology，2005，103（3）：613-618．
[13] Edwards RR，Haythornthwaite JA，Tella P，et al. Basal heat painthresholds predict opioid analgesia in patients with postherapetic neuralgia [J]. Anesthesiology，2006， 104（6）：1243-1248.
[14] Chen CC，Johnson MI. An investigation into the hypoalgesic effects of high-and low- frequency transcutaneous electrical nerve stimulation（TENS）on experimentally-induced blunt pressure pain in healthy human participants [J]. J Pain，2010，11（1）：53-61.
[15] Vera SS，George H，Benjamin R. Comparison of intravenous doses of dezocine，butorphanol，and placebo for relief of postoperative pain [J]. Clin J Pain，1987，2（4）：239-244.
[16] Galloway FM，Varma S. Double-blind comparison of intravenous doses of dezocine，butorphanol，and placebo for relief of postoperative pain [J]. Anesth Analg，1986，65（3）：283-287.
[17] Wang L，Liu X，Wang J，et al. Comparison of the efficacy and safety between dezocine injection and morphine injection forper-sistence of pain in Chinese cancer patients：a meta-analysis [J]. Biosci Rep，2017，37（3）：BSR20170243.
[18] 严定强，朱怀军，彭婕，等.地佐辛注射液不良反应发生风险因素分析[J].药学与临床研究，2015，23（2）：191-193.
[19] 张蕾，袁红宇，周林福.地佐辛注射液不良反应16例[J].医学临床研究，2015，32（10）：2069-2070. |
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