3种剂量地佐辛抑制瑞芬太尼全麻气管拔管应激反应的临床观察  

Effects of three different doses of dezocine inhibiting stress response of tracheal extubation after remifentanil anesthesia

作　　者：杨禄坤[1] 张荣凯[2] 朱颖娴[1] 周少朋[1] 

机构地区：[1]中山大学附属第五医院麻醉科,广东珠海519000 [2]中山大学附属第五医院骨科,广东珠海519000

出　　处：《中国新药与临床杂志》2012年第10期598-601,共4页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的观察3种不同剂量地佐辛对瑞芬太尼全麻气管拔管应激反应的抑制效果。方法择期在全麻下行单侧甲状腺次全切除术的患者80例,随机分为对照组(C组)、地佐辛低剂量组(D1组)、地佐辛中剂量组(D2组)和地佐辛高剂量组(D3组),每组20例。所有患者均予丙泊酚、瑞芬太尼、顺阿曲库铵和七氟烷维持麻醉。开始缝合切口时,D1组、D2组和D3组分别静脉注射地佐辛0.1、0.2、0.3 mg·kg^(-1),C组给予同等容量氯化钠注射液。记录全麻苏醒期不同观察时间点的生命体征和视觉模拟评分(VAS),记录拔管时间、Riker镇静和躁动评分(SAS)、气管拔管并发症和地佐辛不良反应的发生率。结果 D1组、D2组和D3组平均动脉压(MAP)、心率(HR)、VAS和SAS低于C组,D3组最低,D2组次之,组间比较均有显著差异(P<0.05),4组SpO_2差异无显著意义(P>0.05)。D1组、D2组和D3组拔管时间长于C组,D3组最长,D2组次之,组间比较均有显著差异(P<0.05)。C组拔管并发症发生率45%,D1组10%,D2组和D3组无发生(P<0.05)。D3组地佐辛不良反应发生率20%,C组、D1组和D2组无发生(P<0.05)。结论开始缝合切口时地佐辛0.2 mg·kg^(-1)静脉注射可抑制瑞芬太尼全麻气管拔管应激反应,无不良反应发生。AIM To observe the effects of three different of tracheal extubation after remifentanil anesthesia. METHODS doses of dezocine inhibiting the stress response Eighty patients scheduled to undergo unilateral subtotal thyroidectomy were randomly allocated into four groups （n = 20 each） ： control group （group C）, low dose dezocine group （group D1）, medium dose dezocine group （group D2） and high dose dezocine group （group D3） . Anesthesia was equally maintained with propofol, remifentanil, cisatracurium and sevoflurane in all patients. Patients in the group D1, group D2 and group D3 were intravenously administered with dezocine 0.1, 0.2, 0.3 mg ·kg^-1 respectively when beginning to sew up the incision while patients in group C were intravenously administered with an equal amount of sodium chloride injection. Mean artery pressure （MAP） , heart rate （HR）, saturation of pulse oxygen （SpO2） and visual analogue score （VAS） were recorded at different time points during recovery from general anesthesia. Tracheal extubation time, Riker＇ s sedation- agitation scale （SAS）, tracheal extubation complications （choke cough and laryngospasm） and dezocine adverse reactions （nausea, vomiting and dizziness） were also recorded. RESULTS The levels of MAP, HR, VAS and SAS were significantly lower in the group D1, group D2 and group D3 compared with those in the group C, and these indexes were lowest in the group D3 and lower in the group D2 （P 〈 0.05）. No differences were found with SpO2 among four groups （P 〉 0.05）. Tracheal extubation time in the group D1, group D2 and group D3 was longer than that in the group C, and it was longest in the group D3 and longer in the group D2 （P 〈 0.05） . The incidence rate of tracheal extubation complications was respectively 45% （9/20）, 10% （2/ 20） in the group C and group D1, while no occurred in the group D2 and group D3 （P 〈 0.05）. The incidence rate of dezocine adverse reactions was 20% （4/20） in the group D3, w

关 键 词：麻醉 全身 应激 地佐辛 瑞芬太尼 气管拔管 

分 类 号：R971[医药卫生—药品]