摘要
目的探讨不同剂量的地佐辛与芬太尼静脉全身麻醉(简称全麻)腹腔镜术后苏醒期的关系。方法 100例拟行腹腔镜手术的成年患者,按照随机数表法,行双盲试验,随机分为观察组四组(A1组、A2组、A3组、A4组)和对照组(B组),每组20例。观察组和对照组麻醉诱导后均使用丙泊酚+芬太尼行麻醉维持,术毕前15 min,A1组、A2组、A3组、A4组分别予以静脉注射地佐辛80、60、40、20μg/kg,B组予以静脉注射生理盐水10 ml,观察并记录患者睁眼时间、呼吸恢复时间、拔管时间、疼痛视觉模拟评分(VAS)及躁动不良反应。结果术后苏醒期睁眼时间:A1、A2组患者较A3、A4及B组明显延长(P<0.05),A3、A4组较B组也延长(P<0.05);呼吸恢复时间及拔管时间:A1、A2组患者较A3、A4、B组明显延长(P<0.05);VAS评分:A1、A2、A3组患者明显低于A4、B组(P<0.05);苏醒期躁动情况为:A1组3例,A2组5例,A3组4例,A4组7例,B组12例,A组与B组差异具有统计学意义(P<0.05)。结论地佐辛40μg/kg对于芬太尼静脉全麻腹腔镜手术患者,可较明显的减少术后疼痛及苏醒期躁动的发生率。
Objective To explore the relationship between different doses of dezocine and fentanyl through vein in revive period after general anesthesia laparoscopic surgery. Methods A total of 100 adult patients undergoing laparoscopic surgery were divided into four observation groups（group A1, group A2, group A3, group A4） and control group（group B） with 20 cases in each group according to double blind clinical trial by random number table. All the groups received propofol ＋ fentanyl for anesthesia maintenance after anesthesia induction. In 15 min before the end of surgery, different doses of dezocine through intravenous injection were given to group A1, group A2, group A3, and group A4 by respectively 80, 60, 40, and 20 μg/kg. The group B received 10 ml of normal saline through intravenous injection. Observation and records were made on patients＇ eye open time, breathing recovery time, extubation time, visual analogue scale（VAS）, and dysphoria adverse reactions. Results The group A1 and group A1 had much longer time of postoperative eye open in revive period than the group A3, group A4, and group B（P〈0.05）, and that of group A3 and group A4 was also longer than group B（P〈0.05）. The breathing recovery time and extubation time were also longer in group A1 and group A2 than in group A3, group A4, and group B（P〈0.05）. The group A1, group A2, and group A3 had lower VAS scores than group A4 and group B（P〈0.05）. The situation of dysphoria in revive period was showed in 3 cases of group A1, 5 cases of group A2, 4 cases of group A3, 7 cases of group A4, and 12 cases of group B. The difference between group A and group A had statistical significance（P〈0.05）. Conclusion The application of dezocine by 40μg/kg can remarkably reduce postoperative pain and incidence of dysphoria in revive period in patients undergoing general anesthesia by fentanyl through vein laparoscopic surgery.
出处
《中国实用医药》
2015年第5期21-23,共3页
China Practical Medicine
基金
广东省潮州市医学科研项目"潮卫科研201449"号项目基金资助研究
关键词
地佐辛
芬太尼
腹腔镜
苏醒期
Dezocine
Fentanyl
Laparoscope
Revive period
