地佐辛与舒芬太尼对减轻全子宫切除术中牵拉反应的比较  

Comparison of effects of Dezocine and Sufentanil on reducing visceral traction in hysterectomy

作　　者：李滨[1,2] 陈晓光[1] 颜红军[2] 

机构地区：[1]中国医科大学附属第一医院麻醉科,沈阳110001 [2]沈阳医学院沈洲医院麻醉科,110002

出　　处：《中国医疗前沿》2013年第18期6-7,共2页China Healthcare Innovation

摘　　要：目的观察地佐辛与舒芬太尼静脉辅助用药对预防腰硬联合阻滞麻醉下全子宫切除术中牵拉反应的作用及不良反应。方法将ASA分级Ⅰ-Ⅱ级、拟于腰硬联合阻滞麻醉下行子宫肌瘤全子宫切除术的患者60例随机分成三组各20例。切皮前S组静注舒芬太尼10μg,D1组静注地佐辛5mg,D2组静注地佐辛10mg,三组均常规吸氧。记录入室(T1)、给药前(T2)、给药后15min(T3)、打开腹膜时(T4)、探查子宫时(T5)、断子宫韧带时(T6)、擦拭腹腔时(T7)各时间点的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)、Ramsay镇静评分、VAS疼痛评分、内脏牵拉反应评分。结果 S组与D2组患者一般情况比较、Ramsay评分、VAS评分、MAP、HR、SPO2差异无统计学意义(P>0.05),D1组内脏牵拉反应评分高于S组和D2组(P<0.05)。结论地佐辛与舒芬太尼预防内脏牵拉反应的效果良好,且作用相当,但地佐辛的恶心、呕吐、呼吸抑制等不良反应少。Objective To investigate the prevention effects of intravenous dezocine and sufentanil on visceral traction reaction during hysterectomy under the spinal-epidural anesthesia. Methods Sixty ASAⅠ -Ⅱpatients, scheduled for hysterectomy under the spinal-epidural anesthesia, were randomly divided into three groups(n=20): sufentanil 10μg(S group), dezocine 5mg(D1 group) and dezocine 10mg(D2 group). MAP, HR, SpO2, Ramsay sedation score, VAS pain score and visceral traction reaction were recorded separately at different time points as follows: Baseline(T1), before administration(T2), 15 minutes after administration(T3), to open the peritoneum(T4), when the uterus probe(T5), breaking the uterine ligaments(T6), wipe the abdominal cavity(T7). Results S group and D2 group of patients with relatively normal circumstances, Ramsay score, VAS score, MAP, HR,and SPO2 was no significant difference(P>0.05), D1 group visceral reaction score higher than S and D2 group(P<0.05). Conclusion Dezocine 10 mg IV is as effective as sufentanil in preventing visceral reaction during hysterectomy, with less incidence of nausea, vomiting and respiratory depression.

关 键 词：地佐辛 枸橼酸舒芬太尼 腰硬联合阻滞麻醉 内脏牵拉反应 全子宫切除术 

分 类 号：R614.4[医药卫生—麻醉学] R713.4[医药卫生—外科学]