等效镇痛剂量舒芬太尼、芬太尼、地佐辛对意识指数的影响和不良反应的比较  

Comparison of effects of equivalent analgesic dose of sufentanil,fentanyl and dezocine on consciousness index and their adverse reactions

作　　者：孙茗 刘骥[1] 韩晓林 淡雄玉 谢丽莎 方伟武[1] SUN Ming;LIU Ji;HAN Xiaolin;DAN Xiongyu;XIE Lisha;FANG Weiwu(The 306th Hospital of PLA,Beijing 100101,China)

机构地区：[1]中国人民解放军第306医院麻醉手术科,北京100101

出　　处：《实用医学杂志》2019年第3期445-448,共4页The Journal of Practical Medicine

摘　　要：目的比较等效镇痛剂量舒芬太尼、芬太尼、地佐辛对意识指数(IoC)的影响和不良反应。方法择期无痛胃肠镜患者80例,年龄18～60岁,ASAⅠ～Ⅱ级。采用随机数字表法,随机分为4组(n=20);对照组(C组)、舒芬太尼组(S组)、芬太尼组(F组)、地佐辛组(D组)。S组、F组、D组分别静脉滴注舒芬太尼0.1～0.2μg/kg、芬太尼1～2μg/kg、地佐辛0.1～0.2 mg/kg,C组给予等容量生理盐水,随后静注丙泊酚2～2.5 mg/kg至意识消失。静脉泵注丙泊酚50～100μg/(kg·min)维持麻醉。记录心率、血压、IoC值以及围术期不良事件发生情况。结果 4组患者手术时间以及苏醒时间比较差异无统计学意义(P> 0.05)。与C组比较,S组、F组给药后T2、TS、T4、T5时点IoC值明显升高(P <0.05),OAA/S与IoC之间的相关系数为0.872(P <0.05)。与C组比较,D组恶心呕吐发生率升高,S组、F组和D组注射痛发生率明显降低(P <0.05)。结论与单纯使用丙泊酚相比,阿片类药物用于无痛胃肠镜检查术麻醉时导致患者意识消失与恢复时点IoC值升高,对苏醒时间并无显著影响。Objective To compare the effects of the equivalent analgesic doses of sufentanil,fentanyl and dizosin on index of consciousness(IoC)and their adverse reactions. Methods Eighty patients undergoing painless gastroenteroscopy,aged 18 ~ 60 years,ASA grade Ⅰto Ⅱ,were selected. The patients were randomly divided into control group(group C),sufentanil group(group S),fentanyl group(group F),and dizosin group(group D),with 20 cases in each group. Sufentanil 0.1 ~ 0.2 μg/kg,fentanyl 1 ~ 2 μg/kg and dizocine 0.1 ~ 0.2 mg/kg were intravenously injected in group S,F and D respectively. Group C was given saline of equal volume,and then propofol 2 ~ 2.5 mg/kg was intravenously injected until consciousness disappeared. Intravenous infusion of propofol 50 ~ 100 g/(kg·min)maintained anesthesia. Heart rate,blood pressure,IoC and perioperative adverse events were recorded. Results There was no significant difference in operative time and recovery time among the 4 groups (P > 0.05). Compared with those in group C,the values of IoC at T2,TS,T4 and T5 in group S and F increased significantly(P < 0.05),and the correlation coefficient between OAA/S and IoC was 0.872(P < 0.05). Compared with that in group C,the incidence of nausea and vomiting was higher in group D,and the incidence of injection pain was significantly lower in group S,F and D(P < 0.05). Conclusion Compared with propofol alone,opioids used in painless gastrointestinal endoscopy anesthesia lead to loss of consciousness and increase of IoC value at recovery time,but have no significant effect on recovery time.

关 键 词：意识指数 不良反应 镇静 阿片类 

分 类 号：R614[医药卫生—麻醉学]