地佐辛预处理对妇科腹腔镜手术后镇痛效果的影响  

The Effect of Preoperative of Dezocine on Postoperative Analgesia after Gynecological Laparoscopic Surgery

作　　者：王明玲[1] 

机构地区：[1]潍坊医学院麻醉学系,山东潍坊261053

出　　处：《潍坊医学院学报》2015年第4期308-311,共4页Acta Academiae Medicinae Weifang

摘　　要：目的：观察术前肌肉注射小剂量地佐辛对妇科腹腔镜手术术后病人镇痛效果的影响。方法选择择期在全身麻醉下行腹腔镜下子宫肌瘤剔除术、卵巢肿瘤切除术的病人60例，ASAⅠ～Ⅱ，随机等分为地佐辛（D）组与生理盐水对照（C）组，每组30例，D组病人于麻醉诱导前10min肌肉注射地佐辛0．1mg／kg，C组病人肌肉注射等体积的生理盐水。在麻醉诱导及麻醉维持期间两组病人的给药条件均相同。术中持续不断监测两组病人的无创血压（BP）、心率（HR）、脉搏氧饱和度（SPO2）、呼气末二氧化碳分压（ETCO2）、心电图（ECG）及脑电双频谱指数（ SI）。观察并记录术后两组病人呼之睁眼时间、拔管时间、PACU 停留时间，手术结束后10min，20min，30min的Ramsay 镇静程度评分，手术后两组病人苏醒时（T0）、苏醒后2h（T1）、4h（T2）、6h（T3）、12h （T4）、24h（T5）、48h（T6）静息时的疼痛（VAS）评分、BCS舒适度评分，术后镇痛时芬太尼的用量，不良反应的发生率及严重程度。结果与C组病人相比，D组病人在静息状态下于苏醒时、苏醒后2h，4h，8h，12h的VAS评分明显降低，BCS舒适度评分在苏醒时、苏醒后2h，4h明显升高，术后D组病人自控镇痛所需的芬太尼用量明显减少，而两组病人不良反应的发生率及严重程度相似。结论术前单次肌肉注射地佐辛0．1 mg／kg可有效减轻妇科腹腔镜手术病人手术后疼痛并明显减少术后病人自控镇痛时所需的芬太尼用量。Objective To observe the effect of preoperative administration of intramuscular of dezocine on postoperative analgesia after gynecological laparoscopic surgery .Methods Sixty Patients （ ASA Ⅰor Ⅱ） scheduled for laparoscopic myomectomy and ovarian tumor resection were randomly divided into intramuscular dezocine group （ group D） and intramuscular normal saline group （ group C ） ,30 cases in every group .The patients in group D were injected muscle 0.1mg/kg dezocine at 10min before the induction of anesthesia and equal volume normal saline was injected in-tramuscularly to the patients in group C .The administered conditions were the same in the patients of two groups during anesthesia induction and maintenance of anesthesia .Non-invasive blood pressure ,heart rate ,pulse oxygen saturation ,end tidal carbon dioxide partial pressure ,electrocardiogram and bispectral index were monitored continuously in two groups . After operation,the recorvery time,extubation time and the time of staying at postanesthesia care unit were recorded .The Ramsay scores were assessed at 10min,20min and 30min after operation and VAS and BCS scores were assessed at the time of patients awaking ,2 hours,4 hours,12 hours,24 hours and 48 hours.The incidence and severity of side-effects and the requirement of fentanyl for postoperative analgesia were assessed .Results The rest VAS scores of the patients in group D were significantly reduced at the time of awaking ,2 hours,4 hours and 12 hours after waking compared with the patients in the group C （ P＆lt;0.05）.The BCS comfort scores of the patients in group D were significantly higher than those in group C at the time of awaking ,2 hours and 4 hours after waking .The requirements of fentanyl which was used for postoperative patient-controlled analgesia were reduced significantly in group D compared with group C .The incidence and severity of side effects were similar between the two groups .Conclusion Preoperative single intramuscular injection of dezocine 0 .1 mg/kg could

关 键 词：地佐辛 术后镇痛 妇科腹腔镜手术 

分 类 号：R614[医药卫生—麻醉学]