地佐辛与瑞芬太尼用于经腹腔镜直肠癌根治手术中麻醉镇痛的效果  

The anesthesia and analgesia effect of dezocine and remifentanil in the laparoscopic radical resection of rectal cancer

作　　者：潘正举 莫品军 谭健 刘璐 蒙兴虹 PAN Zhengju;MO Pinjun;TAN Jian;LIU Lu;MENG Xinghong(Anesthesiology Department,the Third Affiliated Hospital of Guizhou Medical University,Duyun558000,China)

机构地区：[1]贵州医科大学第三附属医院麻醉科,贵州都匀558000

出　　处：《中国现代医生》2021年第26期142-145,共4页China Modern Doctor

摘　　要：目的 探讨地佐辛与瑞芬太尼用于经腹腔镜直肠癌根治手术中麻醉镇痛的效果。方法 选取2017年1月至2020年12月我院收治的76例经腹腔镜直肠癌根治手术患者,随机分为两组,对照组应用瑞芬太尼麻醉,研究组应用地佐辛麻醉。比较两组患者各时点HR、MAP、Narcotrend指数及SAS、VAS、BCS评分。结果 麻醉前、切皮时、气腹建立时、组织分离时、手术结束时两组HR、MAP没有明显差异(P>0.05),与对照组比较,拔管时、拔管后10 min研究组HR、MAP更低(P>0.05);麻醉前、切皮时、气腹建立时、组织分离时、手术结束时两组Narcotrend指数没有明显差异(P>0.05),与对照组比较,拔管时、拔管后10 min研究组Narcotrend指数更低(P<0.05);与对照组比较,研究组各时点SAS、VAS评分更低, BCS评分更高(P<0.05)。结论 对经腹腔镜直肠癌根治手术患者进行地佐辛麻醉,镇痛效果明显,安全性高,不会对HR、MAP产生明显影响,可维持血流动力学稳定。因此,地佐辛麻醉值得广泛应用。Objective To explore the anesthesia and analgesia effect of dezocine and remifentanil in laparoscopic radical resection of rectal cancer.Methods A total of 76 patients who underwent laparoscopic radical resection of rectal cancer in our hospital from January 2017 to December 2020 were selected and randomly divided into two groups.The control group was anesthetized with remifentanil and the study group was anesthetized with dezocine.The HR,MAP,Narcotrend index and SAS,VAS and BCS scores of patients at each time point were compared in the two groups.Results Before anesthesia,during skin excision,when pneumoperitoneum was established,at the time of tissue isolation,and at the end of surgery,HR and MAP showed no significant differences in the two groups(P>0.05);HR and MAP scores were lower in the study group than those in the control group at the time of extubation and at 10 min after extubation(P<0.05).SAS and VAS scores were lower and BCS scores were higher in the study group than those in the control group at all time points(P<0.05).Conclusion Dezocine anesthesia for patients undergoing laparoscopic radical resection of rectal cancer is associated with marked analgesic effect and high safety.It will not have significant impacts on HR and MAP,and can maintain hemodynamic stability.Therefore,dezocine anesthesia deserves applying widely.

关 键 词：地佐辛 瑞芬太尼 经腹腔镜直肠癌根治手术 麻醉效果 镇痛效果 

分 类 号：R614[医药卫生—麻醉学]