地佐辛复合芬太尼辅助臂丛神经阻滞的临床效果观察  

Clinical effect observation of dezocine combined with fentanyl as adjuvant therapy in brachial plexus block

作　　者：庞哲[1] 张北忠[1] 

机构地区：[1]大同市第五人民医院麻醉科,大同037006

出　　处：《中国当代医药》2015年第5期82-83,86,共3页China Modern Medicine

摘　　要：目的观察地佐辛复合芬太尼辅助臂丛神经阻滞的临床麻醉效果。方法选择本院2012年5月～2014年5月收治的80例18～65岁的需要臂丛神经阻滞患者,ASAⅠ～Ⅱ级,将其随机分为地佐辛复合芬太尼组（A组）和芬太尼组（B组）,每组40例,A组于臂丛神经阻滞完成后,手术切皮前15 min静点地佐辛和芬太尼;B组于臂丛神经阻滞完成后,手术切皮前15 min静点芬太尼。记录切皮（T0）、手术30 min（T1）、手术60 min（T2）、手术结束时（T3）、术后4 h（T4）的心率（HR）、动脉压（MAP）及VAS评分,观察术中及术后4 h患者有无恶心、呕吐,Sp O2有无降低。结果 A组患者T0、T1、T2、T3、T4的HR、MAP及VAS评分均低于B组,差异有统计学意义（P〈0.05）;两组患者术中Sp O2均不下降且术中及术后4 h回访两组患者恶心、呕吐发生率差异无统计学意义（P〉0.05）。结论地佐辛复合芬太尼辅助臂丛神经阻滞麻醉与单纯芬太尼辅助臂丛神经阻滞麻醉相比,镇痛效果明显,镇痛时间延长,两组术中和术后副反应差别不明显。Objective To observe the clinical anesthetic effect of dezocine combined with fentanyl as adjuvant therapy in brachial plexus block. Methods 80 patients who were from 18 to 65 years old in classification of Ⅰ and Ⅱ based on American society of anesthesiologists （ASA） and needed brachial plexus block in our hospital from May 2012 to May 2014 were selected,and were evenly divided into group A and group M in random.After completion of brachial plexus block,dezocine combined with fentanyl for intravenous drip was provided 15 minutes before skin incision in group A, and only fentanyl for intravenous drip was used 15 minutes before skin incision in group B.Heart rate （HR）,mean arterial pressure （MAP） and visual analogue scale （VAS） was recorded at incision （T0）,surgery 30 rain （T1）,surgery 60 rain （T2）,at the end of surgery （T3）,after 4 h surgery （T4）;with or without nausea and vomiting,SpO2 whether decrease during and after 4 h surgery was observed. Results HR,MAP,VAS at T0,T1,T2,T3,T4 in group A was lower than that in group B, the difference was significant （P〈0.05）.There was no significant difference about the incidence of oxygen saturation （SpO2） decrease,nausea,or vomiting in the two groups during or 4 hours after surgery. Conclusion Compared with single fentanyl as adjuvant therapy in brachial plexus block,dezocine combined with fentanyl can obtain a great anesthetic effect and prolong analgesic time.There is no obvious side effect during and after surgery.

关 键 词：地佐辛 芬太尼 臂丛神经阻滞 

分 类 号：R614.4[医药卫生—麻醉学]