地佐辛对瑞芬太尼闭环靶控输注麻醉的影响  

Effect of Dezocine on Remifentanil with Intravenous Anesthesia by Closed-loop Target-controlled Infusion

作　　者：周忠群[1] 王喜连[1] 陈素昌[1] 胡啸玲[1] 

机构地区：[1]南华大学附属第一医院麻醉科,湖南衡阳421001

出　　处：《中南医学科学杂志》2013年第4期405-407,411,共4页Medical Science Journal of Central South China

摘　　要：目的观察瑞芬太尼闭环靶控输注(CLTCI)静脉全麻下行腹腔镜胆囊切除术(LC)时,地佐辛对瑞芬太尼的血浆靶浓度和术后疼痛的影响。方法 ASAⅠ-Ⅱ级择期行LC的病人60例,经本院道德伦理委员会批准随机分成地佐辛组和安慰剂组,每组30例。在诱导前30 min,地佐辛组静脉注射地佐辛10 mg,安慰剂组给予等量(2 mL)生理盐水。术中瑞芬太尼以平均动脉压(MAP)和心率(HR)作为反馈指标进行CLTCI,其余麻醉药物使用相同。记录术中各时刻瑞芬太尼血浆靶浓度、MAP、HR、苏醒期躁动例数、术后视觉模拟评分(VAS)。结果两组病人术中MAP、HR稳定,地佐辛组各时刻瑞芬太尼血浆靶浓度明显低于安慰剂组(P<0.05);地佐辛组苏醒期躁动发生例数明显少于安慰剂组(P<0.05);地佐辛组术后VAS评分明显低于安慰剂组(P<0.05)。结论瑞芬太尼CLTCI静脉全麻行LC时,术前使用地佐辛能明显降低术中瑞芬太尼血浆靶浓度,减少苏醒期躁动的发生率,有效缓解术后疼痛。Objective To observe the effect of dezocine on remifentanil target plasma concentration and postopera- tive pain following laparoscopic eholecysteetomy （ LC ） for intravenous anesthesia with remifentanil by closed-loop target- controlled infusion （ CLTCI ）. Methods Sixty patients with ASA I - II that were scheduled for LC were randomly divid- ed into dezoeine group and placebo group with 30 cases in each group. Dezocine group received dezoeine of 10mg infusion and placebo group received saline of equal volume（ 2 mL） in 30 minutes before induction of anesthesia. Remifentanil was applied to CLTCI by mean arterial pressure（MAP） and heart rate（HR） for induction and maintenance of anesthesia. The target plasma concentration of remifentanil and the changes of MAP and HR were recorded in each time point in operation. The cases of restlessness during recovery period and the visual analogue scale （VAS） of postoperative pain were recorded. Results The hemodynamics was stable in two groups. The target plasma concentration of remifentanil was lower obviously in dezocine group than placebo group （ P 〈 0. 05 ）. The cases of restlessness during recovery period were obviously less in dezocine group than placebo group（ P 〈 0. 05 ）. The VAS score was lower obviously in dezoeine group than placebo group （P 〈 0. 05 ）. Conclusion Dezocine can significantly reduce the target plasma concentration of remifentanil and the inci- dence of restlessness during recovery period, and relieve postoperative pain at LC for intravenous anesthesia with propnfol combined with remifentanil by CLTCI .

关 键 词：地佐辛 瑞芬太尼 闭环靶控输注 

分 类 号：R614[医药卫生—麻醉学]