等效剂量地佐辛或芬太尼在鼻内窥镜手术中的疗效观察  

Observation on Clinical Efficacy of Equivalent Dose of Dezocine or Fentanyl During Nasal Endoscopic Surgery

作　　者：聂晓舟 邓恢伟[1] 潘道波[1] 陈安基[1] 周爱国[1] 黄芙蓉[1] 郭华静[1] 

机构地区：[1]常德市第一人民医院麻醉科,湖南常德415003

出　　处：《临床医药文献电子杂志》2015年第6期994-995,997,共3页Electronic Journal of Clinical Medical Literature

摘　　要：目的：观察等效剂量地佐辛或芬太尼在鼻内窥镜手术中的疗效。方法60例择期行鼻内窥镜手术患者，年龄20-60岁，体重45-70 kg，ASA I级，随机分为地佐辛组（D组）和芬太尼组（F组）（n=30），均实施静吸复合麻醉。在插管前5 min分别静脉注射地佐辛0.2 mg/kg（D组）、芬太尼4μg/kg（F组），其余诱导药相同，丙泊酚2 mg/kg，苯磺顺阿曲库铵0.2 mg/kg。于麻醉诱导前（T0）、插管前1 min （T1）、插管后即刻（T2）、插管后5 min（T3）、拔管后1 min（T4）、5 min（T5）、15 min（T6）时观察两组患者HR、MAP、SpO2、PETCO2、T4-6潮气量（VT）、呼吸频率（RR）及诱导期和苏醒期不良反应发生情况。结果两组患者一般资料、麻醉时间、HR、MAP、SpO2等指标组间比较差异无统计学意义（P＞0.05）。与T0比较，D和F组T4-T5 PETCO2均增高，F组T4 RR降低（P＜0.05）。D组术后苏醒时间较长，镇静满意率较高，术后躁动发生率较低（P＜0.05）。结论地佐辛可安全用于鼻内窥镜手术的麻醉，较芬太尼能减少术后不良反应的发生率。Objective To detect the clinical efifcacy of equivalent dose of dezocine or fentanyl during nasal endoscopic surgery.Methods 60 elective nasal endoscopic surgery patients aged 20-60 years,weighted 45-70 kg,ASA I were selected and randomly divided into 2 groups with 30 in each,the dezocine group（group D） and the fentanyl group（group F）.The 2 groups adopted intravenous inhalation anesthesia.Dezocine 0.2 mg/kg（group D） and fentanyl 4.0 μg/kg（group F） were given with intravenous injection before 5 min of inserting tracheal catheter, Propofol 2mg/kg,Benzene sulfonyl cisatracurium 0.2 mg/kg.Heart rate（HR）、mean arterial pressure（MAP）、pulse oxygen saturation（SpO2）、end tidal carbon dioxide patial pressure（PETCO2）、tidal volume（VT）、respiratory rate（RR） and situation of recovery period were recorded before induction（T0）,1 min before inserting laryngeat mask（T1）,immediately（T2）、5 min（T3） after inserting tracheal catheter and 1 min（T4）、5 min（T5）、15 min（T6） after pulting tracheal catheter. Results No significant difference was found between the 2 groups in anesthetic time,HR、MAP、SpO2（P＆gt;0.05）. Compared with at T0,the levels of PETCO2 at T4-T5 were increased in group D and F（P〈0.05）,the levels of RR at T4 were decreased signiifcantly in group F（P〈0.05）;Compared with group F,the wake-up time was longer and the incidence of agitation at recovery period was lower in group D（P〈0.05）. Conclusion Dezocine was safety during nasal endoscopic surgery and it could relieve the incidence of adverse effect post-operation compared with fentanyl.

关 键 词：地佐辛 鼻内窥镜手术 全身麻醉 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]