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

Z.-Y. Yao, Z. Jia, Y.-H. Xie, L.-L. Zhang, H.-S. Zhang, W.-Q. Wu, C.-K. Zhang, L.-J. Gan

Department of Anesthesiology, Qinghai Red Cross Hospital, Qinghai, China. 13792336453@163.com

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• Pharmacology

OBJECTIVE: To study the analgesic effect of dezocine in different doses on elderly patients undergoing abdominal operation under general anesthesia and to investigate the influence of dezocine on stress response to postoperative tracheal extubation.

PATIENTS AND METHODS: A total of 76 elderly patients undergoing abdominal operation under general anesthesia and postoperative analgesia in our hospital from January 2015 to January 2016 were selected, and patients treated with fentanyl were selected as the control group (fentanyl: 10 μg/kg, n=19). The patients were randomly divided into low-dose group (dezocine: 0.05 mg/kg, n=19), medium-dose group (dezocine: 0.1 mg/kg, n=19) and high-dose group (dezocine: 0.15 mg/kg, n=19). The patients in each group were intravenously injected with 0.1 mg/kg tropisetron. The tracheal catheter was withdrawn from patients in each group; the heart rate (HR), respiratory rate (RR), mean arterial pressure (MAP) and saturation of pulse oxygen (SpO2) of patients in each group before and at 10 min after tracheal extubation were recorded in detail; moreover, the visual analogue scale (VAS) score, Ramsay sedation score, occurrence rate of adverse reactions, Bruggrmann comfort scale (BCS) score and times of pressing analgesia pump after operation of patients in the four groups were evaluated at 4, 8, 12, 24 and 48 h after operation.

RESULTS: Compared with those before operation, there were no statistically significant differences in HR, RR, MAP and SPO2 of patients in low-dose group, medium-dose group and high-dose group at 10 min after tracheal extubation, and HR, RR, MAP and SPO2 of patients in control group were significantly increased after tracheal extubation (p<0.05). The VAS scores of patients in low-dose group within 48 h were significantly higher than those in control group, medium-dose group and high-dose group (p<0.05). The Ramsay sedation scores of patients in low-dose group and medium-dose group were significantly lower than those in control group and high-dose group (p<0.05), and the BCS score of patients in low-dose group was lower than those in medium-dose group, high-dose group, and control group (p<0.05). Besides, the occurrence rates of postoperative adverse reactions of patients in control group and low-dose group were higher than those in medium-dose group and high-dose group (p<0.05), the times of pressing analgesia pump after operation of patients in low-dose group were more than those in control group, medium-dose group and high-dose group (p<0.05), and the times were reduced successively in low-dose group, medium-dose group, and high-dose group. Finally, the results of correlation analysis showed that the dose of dezocine was positively correlated with the Ramsay sedation score, but negatively correlated with the VAS score of patients.

CONCLUSIONS: Dezocine can effectively enhance the analgesic effect on elderly patients receiving abdominal operation under general anesthesia in a dose-dependent manner. Moreover, dezocine can significantly reduce the stress response of elderly patients to postoperative tracheal extubation, and reduce the occurrence rate of adverse complications after abdominal operation under general anesthesia.

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