摘要
[目的]探讨地佐辛对腹腔镜手术(laparoscopic surgery,LS)超前镇痛的有效性及安全性。[方法]选择96例择期行LS患者,术前按美国麻醉医师协会(ASA)分级评估为Ⅰ～Ⅱ级,手术耐受力良好,麻醉经过平稳,随机均分为三组,均采用静脉复合麻醉,术中靶控输注异丙酚和瑞芬太尼,间断给予顺式阿曲库铵维持肌松。麻醉成功诱导后,实验A组静脉注射地佐辛0.2mg·kg-1,对照B组静脉注射芬太尼4.0μg·kg-1,以及安慰剂C组静脉注射生理盐水2.0mL。观察记录三组患者术中各时点熵指数(SE、RE)的监测结果,同时记录各组患者睁眼时间、术后疼痛视觉模拟评分(VAS)、拔管时间、呼吸恢复时间,并且统计各组患者术后烦躁不安、恶心呕吐、呼吸抑制等不良反应发生率。[结果]术中实验A、对照B组患者在手术操作的应激下熵指数值波动明显<安慰剂C组,有统计学意义(P<0.05);呼吸恢复时间、睁眼时间、拔管时间均明显<安慰剂C组,有统计学意义(P<0.05);在术后VAS评分方面,实验A组比对照B、安慰剂C组明显低,有统计学意义(P<0.05);术后烦躁不安方面,实验A组患者发生率明显<对照B、安慰剂C组,有统计学意义(P<0.05);实验A、安慰剂C组术后恶心呕吐发生率明显<对照B组,有统计学意义(P<0.05)。[结论]地佐辛超前镇痛可明显缓解LS患者的早期疼痛,能有效减轻停药后的痛觉过敏,且不良反应发生率低,安全性、舒适度高,是一种较理想的LS超前镇痛药物。
[Objective] To evaluate the preemptive analgesic efficacy and safety of dezocine injection in patients undergoing laparoscopic surgery.[Methods]96 patients undergoing elective laparoscopic surgery,were randomly divided into three groups,used intravenous anesthesia with endotracheal intubation,intraoperative target controlled infusion of propofol and remifentanil,intermittent given cis-atracurium to maintain muscle relaxants,5min after induction of anesthesia;group A vein injection of dezocine 0.2mg/kg,the group B intravenous injection of fentanyl 4ug/kg,group C received intravenous injection of saline 2 ml.Observe and record the monitoring results of the three groups of patients at each time point entropy indexes（SE,RE）,record at the same time the recovery time from each group of patients with respiratory,eye opening time,extubation time and postoperative pain visual analogue score（VAS）,and nake statistics of each group of patients with irritability,nausea,vomiting,respiratory depression,the incidence of adverse reactions.[Results] Group A and group B patients in the surgical operation under stress,the entropy index value fluctuations significantly were less than the group C,breathing recovery time,eye opening time,extubation time were significantly shorter than group C;the group A patients postoperative VAS score was significantly lower than group B and group C;group A of patients with postoperative irritability incidence was significantly lower than group B and group C;the incidence of postoperative nausea and vomiting of group A and group C was significantly lower than group B.[Conclusion] Dezocine injection preemptive analgesia can significantly alleviate the pain of laparoscopic surgery in patients early,can effectively reduce hyperalgesia after stopping,with a low incidence of adverse reactions,with safety and comfort,it is an ideal preemptive analgesia drug for undergoing laparoscopic surgery.
出处
《浙江中医药大学学报》
CAS
2013年第5期549-551,553,共4页
Journal of Zhejiang Chinese Medical University
关键词
LS
超前镇痛
地佐辛
安全性
有效性
laparoscopic surgery
preemptive analgesia
dezocine
safety
efficacy
