地佐辛联合硬膜外阻滞在腰椎间盘镜手术中应用的安全性评价  

Safety Evaluation of the Application of Dezocine Combined with Epidural Anesthesia in Microscopic Discectomy

作　　者：王劲[1] 李曦[1] 

机构地区：[1]成都医学院第一附属医院麻醉科,成都新都610500

出　　处：《西南军医》2012年第6期809-812,共4页Journal of Military Surgeon in Southwest China

摘　　要：目的探讨腰椎间盘镜手术中应用地佐辛联合硬膜外阻滞的效果及安全性。方法 75例ASAI～II级、择期行腰椎间盘镜手术患者,随机分为I、II、III组,每组25例。各组均行硬膜外阻滞,切皮前15min分别静脉注射地佐辛0.1mg/kg、舒芬太尼0.15μg/kg、生理盐水5ml。记录术前(T0)、切皮时(T1)、术中(手术进行20min)(T2)、术毕(T3)时血压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)、呼吸频率(R);观察术中及术毕1h、4h、8h、12h的VAS评分;观察术中神志及有无呼吸抑制、嗜睡、恶心呕吐、头晕等不良反应。结果 II组术中R、SpO2降低,较I、III组差异有显著性意义(P<0.05);术中VAS评分,I、II组比较差异无显著性意义(P>0.05),对照组III组与I、II组比较差异有显著性意义(P<0.05);术后4h的VAS评分,I组与II、III组比较差异有显著性意义(P<0.05);I组患者未见嗜睡、呼吸抑制、恶心呕吐、头晕等不良反应。结论地佐辛联合硬膜外阻滞用于腰椎间盘镜手术,安全、有效、可提供一定时间术后镇痛。Objective To discuss the effect and safety of dezocine combined with epidural anesthesia applied in microscopic discectomy. Methods 75 cases of ASAI Grade II for selective microscopic discectomy were randomly divided into 3 groups： Group I, Group II and Group III, 25 cases in each; epidural anesthesia was performed to all the patients in the 3 groups while 15 minutes before operation, dezocine of 0.1mg/kg was injected intravenously to patients in Group I, sulfentanyl 0.15~tg/kg to patients in Group II and normal saline 5 ml to patients in Group III; blood pressure, heart beat, SpO2 and respiration frequency before operation （T0）, at the start of operation （T 1 ）, in operation （20 minutes after the operation started） （T2） and when the operation ended （T3） of all the patients were recorded; an observation was made to VAS scores at lh, 4h, 8h and 12h after operation, and the intraoperative con-sciousness and the adverse reaction such as respiratory depression, drowsiness, nausea, vomiting and dizziness were also observed. Results The respiration frequency and SpO2 in operation of the patients in Group II dropped down more than those of the patients in Group I and Group III, the difference was of significance （P〈0.05）; the compari- son of intraoperative VAS scores between Group I and Group II was of no obvious difference （P〉0.05） while the comparison of Group III with Group I and Group II was of significant difference （P〈0.05）; the VAS score of 4h af- ter operation in Group I was of great difference from those in Group II and Group III （P〈0.05）; no adverse reactions such as drowsiness, respiratory depression, nausea, vomiting and dizziness occurred in patients of Group I. Conclu- sions The application of dezocine combined with epidural anesthesia in microscopic discectomy is safe and effective, and it can relieve pain for certain time after operation.

关 键 词：地佐辛 硬膜外麻醉 舒芬太尼 腰椎间盘镜手术 

分 类 号：R681.53[医药卫生—骨科学]