不同剂量地佐辛减轻全麻拔管期心血管反应的比较  

Comparison of the cardiovascular responses between different doses of decozine during general anesthesia recovery

作　　者：于向鸿[1] 黄盛[2] 肖剑鹏[3] 

机构地区：[1]南京军区福州总医院麻醉科,福州市350025 [2]南京军区福州总医院普通外科,福州市350025 [3]南京军区福州总医院内分泌科,福州市350025

出　　处：《临床麻醉学杂志》2013年第3期251-253,共3页Journal of Clinical Anesthesiology

摘　　要：目的比较不同剂量地佐辛对全麻术后围拔管期心血管反应的影响。方法拟在全麻下行择期腹腔镜胆囊切除术患者120例,随机均分为三组。常规麻醉后,分别在手术结束前30min静脉输注地佐辛0.1mg/kg(D1组)、0.2mg/kg(D2组)和2ml生理盐水(对照组,C组)。记录手术前(基础值,T0)、缝皮结束时(T1)、拔管即刻(T2)、拔管后5min(T3)、10min(T4)的BP、HR及术后自主呼吸恢复时间、睁眼时间、拔管时间;记录围拔管期呼吸抑制、呛咳、拔管不良记忆、BP升高、窦性心动过速、嗜睡和术后躁动等不良反应发生率。结果与T0时比较,T2、T3时三组SBP、DBP明显升高,HR明显加快(P<0.05);与C组比较,T2～T4时D1、D2组SBP、DBP明显降低,HR明显减慢(P<0.05)。D2组患者自主呼吸恢复时间、睁眼时间、拔管时间延长,围拔管期呼吸抑制、嗜睡的发生率增加(P<0.05),D1、D2组围拔管期呛咳、拔管记忆、BP升高、窦性心动过速等不良反应发生率明显降低(P<0.05)。结论静脉输注地佐辛能有效地减轻全麻手术后围拔管期心血管反应;且使用地佐辛0.1mg/kg对呼吸影响小,能提高全麻术后的苏醒质量,更为安全。Objective To investigate the influence of different doses of decozine on attenuating cardiovascular responses during tracheal extubation. Methods One hundren twenty patients undergoing elective laparoscopic cholecystectomy under general anesthesia were randomly divided into three groups for each group. The patients received 2 ml of normal saline （group C）, 0. 1 mg/kg of intravenous decozine （group D1）, or 0.2 mg/kg of intravenous decozine （group D2） respectively at 30 minutes before the end of surgery. BP and HR were measured at the time before surgery（T0 ）, the end of skin suture （T1）, immediately before emubation （T2）, at 5 min （Ta） and 10 min （T4） after extubation. The postoperative spontaneous breathing recovery time, awakening time, the extubation time and incidence of side effects including respiratory depression, irritative cough, extubation memory, hypertension, postoperative tachycardia,drowsiness, etc,were also recorded. Results SBP, DBP and HR of all the three groups increased significantly at T2-Ta from their respective level at To （P〈0.05）, while the values of groups D1 and D2 were significantly lower than those of group C at T2-T4 （P〈0.05）. The incidence of irritative cough, extubation memory, hypertension, sinus tachycardia during tracheal extubation in patients of groups D1 and D2 was significantly lower （P% 0. 05） than those in group C. However, recovery time of spontaneous breathing, eye-opening time, extubation time of patients in group D2 were delayed, and the incidence of respiratory depression and drowsiness during tracheal extubation increased （P〈0.05 ）. Conclusion Intravenous decozine can effectively alleviate cardiovascular responses; during tracheal extubation after general anesthesia. 0.1 mg/kg of intravenous decozine has less influence on respiration, indicating that this dosage can improve the oualitv of recovery in a safer way.

关 键 词：全身麻醉 地佐辛 心血管反应 

分 类 号：R614[医药卫生—麻醉学]