地佐辛对腹腔镜胆囊切除术全麻拔管期躁动的影响  

Effect of dezocine on extubation agitation after laparoscopic cholecystectomy

作　　者：赵戈[1] 原大江[1] 李宏峰[1] 张朝旭[2] 

机构地区：[1]山西医科大学第二临床医学院麻醉科,太原030001 [2]武警山西总队医院麻醉科

出　　处：《山西医科大学学报》2014年第5期428-431,共4页Journal of Shanxi Medical University

摘　　要：目的观察地佐辛对预防腹腔镜胆囊切除术(LC)全麻拔管期躁动的有效性和安全性。方法择期全麻下行LC患者90例,ASAⅠ-Ⅱ级,年龄30-60岁。采用随机数字表法将患者平均分为三组(n=30),并给与不同处理:对照组(C组),曲马多组(tramadol,T组),地佐辛组(dezocine,D组)。手术结束前30 min,分别注射生理盐水(normal saline,NS)2 ml、曲马多1 mg/kg、地佐辛0.1 mg/kg。于诱导前(T0)、拔管时(T1)和拔管后10 min(T2)记录患者平均动脉压(MAP)、心率(HR)。记录T1时患者的呛咳程度、躁动评分,T2时镇静和疼痛评分以及副作用的发生例数。结果三组MAP和HR于T1时均较T0时明显升高(P<0.01),T组和D组T1、T2时的MAP和HR均明显低于C组(P<0.01),T组T1、T2时的MAP和HR与D组比较差异无统计学意义(P>0.05)。T1时呛咳程度和躁动评分T组和D组明显优于C组(P<0.01),T组和D组呛咳程度和躁动评分比较差异无统计学意义(P>0.05)。T2时T组和D组镇静和疼痛评分明显优于C组(P<0.01),D组镇静评分明显优于T组(P<0.01),T组和D组疼痛评分比较差异无统计学意义。D组副作用明显少于T组(P<0.01)。结论地佐辛能有效、安全地预防LC全麻拔管期躁动。Objective To evaluate the efficiency and safety of dezocine sodium for extubation agitation after laparoscopic cholecystectomy（LC）. Methods Using the method of random number table,ninety patients（30- 60 years old,ASAⅠ- Ⅱ） undergoing general anesthesia for LC were divided into three groups（n = 30）. At 30 min before the end of operation,the patients were given intravenously 2 ml of normal saline solution（ NS） in control group,1 ml tramadol hydrochloride in tramadol group and 0. 1 ml dezocine in dezocine group. Mean arterial pressure（MAP） and heart rate（HR） were monitored and recorded before induction（T0）,at extubation（T1） and 10 min after extubation（T2）. Irritating cough and dysphoria scores were recorded at T1. Pain and sedation scores and adverse reactions were recorded at T2. Results There was no significant difference in MAP and HR at T1and T2between tramadol group and dezocine group. However,MAP,HR in three groups at T1were significantly higher than those at T0（P〈 0. 01）. The MAP and HR in tramadol group and dezocine group at T1and T2were lower than those in control group（P〈 0. 01）. Irritating cough and dysphoria scores in tramadol group and dezocine group at T1were significantly higher than that in control group（P 〈 0. 01）,but there was no significant difference between tramadol group and dezocine group. Pain and sedation scores in tramadol group and dezocine group at T2were higher than those in control group（P 〈 0. 01）,the sedation score in dezocine group was higher than that in tramadol group（P 〈 0. 01）,while there was no significant difference in pain scores between tramadol group and dezocine group. The adverse reaction in dezocine group was obviously lower than in tramadol group（P 〈 0. 01）. Conclusion Dezocine can effectively and safely prevent the extubation agitation after laparoscopic cholecystectomy（LC）.

关 键 词：地佐辛 腹腔镜胆囊切除术 全身麻醉 拔管期躁动 

分 类 号：R614[医药卫生—麻醉学]