地佐辛对老年患者全麻苏醒的影响  

Effects of dezocine on recovery quality from general anesthesia in the elderly patients

作　　者：高光洁[1] 尚宇[1] 杨闻宇[1] 吕红梅[1] 赵璠[1] 宋丹丹[2] 

机构地区：[1]中国人民解放军第463医院麻醉科,沈阳市110042 [2]沈阳军区总医院麻醉科

出　　处：《临床麻醉学杂志》2013年第10期1000-1002,共3页Journal of Clinical Anesthesiology

摘　　要：目的评价地佐辛对老年患者全身麻醉苏醒的影响。方法老年腹部肿瘤（胃癌和结直肠癌）切除手术患者60例，年龄65-75岁，ASAⅠ或Ⅱ级，随机分为三组：地佐辛组（A组）、芬太尼组（B组）和对照组（C组），每组20例。所有患者持续静脉输注丙泊酚4～6mg·kg^-1·h^-1、瑞芬太尼15-20μg·kg^-1·h^-1及间断注射顺苯磺酸阿曲库铵0．05～0．1mg·kg^-1·h^-1维持麻醉。手术结束前20min A、B、C三组分别静脉注射地佐辛0．1mg／kg、芬太尼1μg／kg、生理盐水5ml。记录患者自主呼吸恢复时间、苏醒时间、拔除气管导管时间；拔除气管导管时及拔出气管导管后1、5、10min的MAP、HR、SpO2、Ramsay评分及不良反应；拔管后30min、1h、2h、4h和6h的患者VRS痛觉评分。结果与A组和C组比较，B组患者呼吸恢复时间、苏醒时间和拔管时间均明显延长（P〈0．05）；与A组比较，B组和C组患者在拔管后1、5、10min的MAP明显升高、HR明显增快，且C组明显高或快于B组（P〈0．05）；与A组和B组比较，C组患者在拔管时和拔管后1、5、10min的Ramsay评分明显降低（P〈0．05）；与A组比较，B组和C组患者在拔管后30min、1、2、4和6h的VRS评分明显升高，且C组在拔管后30min、1、2h明显高于B组（P〈0．05）。A组不良反应发生率明显低于B组和C组（P〈0．05）。结论地佐辛用于老年腹部肿瘤切除术患者全身麻醉苏醒迅速，血流动力学稳定，镇静满意，镇痛良好，不良反应少，提高患者苏醒质量。Objective To evaluate the effects of dezoeine on recovery quality for elderly patients undergoing general anesthesia. Methods Sixty cases of elderly patients undergoing abdominal operation （gastric carcinoma and colorectal cancer）,aged 65- 75 years old, ASA grade Ⅰ or Ⅱ, were randomly divided into 3 groups （n=20）：group dezocine（group A）,group fentanyl （group B）,and control group （group C）. All patients received general anesthesia with continuous infusion of remifentanil 4-6 mg·kg^-1·h^-1 , propofol 15-20μg·kg^-1·h^-1 and cisatracurium besylate 0. 05-0. 1 mg·kg^-1·h^-1. At 20 minutes before the end of surgery,patients in groups A,B and C were intravenously iniected with 0. 1 mg/kg dezocine, and 1μg/kg fentany and 5 rnl saline respectively. Spontaneous breathing recovery time, awakening time and extubation time of all patients were recorded. At and after extubationl,5,10 min, MAP, HR, SpO2 ,Ramsay scores and untoward effect of all patients were monitored. At 30 min, 1 h,2 h,4 h and 6 h after extubation, VRS pain scores of all patients was recorded. Results Compared with group A, spontaneous breathing recovery time,awakening time and extubation time in group B were significantly prolonged （P〈 0. 05）. After extubationl,5.10 min,the MAP and HR in the groups B and C elevated obviously, significantly higher in group C（P〈0. 05）. At and after extubationl, 5, 10 min, the Ramsay scores in group A and B elevated obviously, significantly higher than those in group C（P〈0. 05）; At 30 min, 1 h, 2 h, 4 h and 6 h after extubation, the VRS pain scores in group B and C elevated obviously, significantly higher in group C than B at 30 min, 1 h and 2 h after extubation （P〈0. 05）; The untoward effect of all patients, group A is lower than the other groups（P〈0. 05）. Condusion Dezocine intravenous injection for elderly patients undergoing general anesthesia can effectively improve the quality of emergence which makes awakening rapid, hemodynamic stable, sedation satisfactory,

关 键 词：地佐辛 老年 全身麻醉 苏醒质量 

分 类 号：R614[医药卫生—麻醉学]