麻醉诱导前静脉预防性给予地佐辛对抑制全身麻醉手术患者诱导期呛咳的效果分析  

The effect of intravenous prophylactic administration of dezocine before anesthesia induction on choking during induction period of patients undergoing general anesthesia

作　　者：陈敏娟 陈南瑾 应颖[1] 林丽娜[1] 王红珠[1] Chen Minjuan;Chen Nanjin;Ying Ying;Lin Lina;Wang Hongzhu(Department of Anesthesiology,Zhejiang Taizhou Hospital,Taizhou 317000,China)

机构地区：[1]浙江省台州医院麻醉科,台州317000

出　　处：《中国医师进修杂志》2022年第12期1109-1112,共4页Chinese Journal of Postgraduates of Medicine

基　　金：2019年台州市路桥区科技计划项目 (2019A23006)。

摘　　要：目的探讨麻醉诱导前静脉预防性给予地佐辛对抑制全身麻醉手术患者诱导期呛咳的效果。方法选取2020年11月至2021年5月在浙江省台州医院行全身麻醉气管插管外科手术患者92例,按随机数字表法分为对照组和观察组,每组46例。对照组麻醉诱导前静脉注射0.9%氯化钠5 ml,观察组静脉注射0.1 mg/kg地佐辛,10 min后两组行麻醉诱导。记录两组麻醉诱导前(T0)、诱导后气管插管前1 min(T1)、插管后1 min(T2)、气管插管后5 min(T3)时的心率(HR)、收缩压(SBP)、舒张压(DBP),并检测儿茶酚胺、白细胞介素-6(IL-6)水平,比较两组呛咳发生率、拔管后躁动评分、视觉模拟量表(VAS)评分、Ramsay镇静评分以及不良反应发生率。结果两组T0、T1、T2、T3时点HR、SBP、DBP水平比较差异无统计学意义(P>0.05)。对照组T2时点儿茶酚胺、IL-6水平高于观察组[(120.49±15.13)ng/L比(113.53±17.14)ng/L、(16.80±2.61)ng/L比(13.46±1.55)ng/L],差异有统计学意义(P<0.05)。观察组恢复自主呼吸时间低于对照组[(8.76±2.14)min比(9.87±2.09)min],差异有统计学意义(P<0.05)。观察组呛咳发生率低于对照组[2.17%(1/46)比21.74%(10/46)],差异有统计学意义(P<0.05)。观察组躁动评分、VAS评分低于对照组[(1.43±0.26)分比(2.11±0.14)分、(3.55±1.03)分比(4.86±1.15)分],Ramsay镇静评分高于对照组[(3.13±0.76)分比(1.54±0.32)分],差异有统计学意义(P<0.05)。观察组不良反应发生率低于对照组[6.52%(3/46)比23.91%(11/46)],差异有统计学意义(χ^(2)=5.39,P<0.05)。结论全身麻醉气管插管患者麻醉诱导前预防注射地佐辛可有效抑制患者应激反应,对呼吸循环系统影响较小,可有效降低诱导期呛咳的发生率。Objective To investigate the effect of intravenous prophylactic administration of dezocine before anesthesia induction on choking during induction period in patients undergoing general anesthesia.Methods A total of 92 patients with tracheal intubation surgery under general anesthesia from November 2020 to May 2021 in the Zhejiang Taizhou Hospital were selected and randomly divided into the observation groupand the control group by random number table,with 46 cases in each group.The observation group was intravenously injected with 0.1 mg/kg dezocine while the control group was intravenously injected with 0.9%sodium chloride 5 ml before anesthesia induction.Anesthesia induction was performed at 10 min after injection in the two groups.Heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP)and catecholamine,interleukin-6(IL-6)levels were recorded at before anesthesia induction(T0),1 min before endotracheal intubation(T1),1 min after intubation(T2),and 5 min after endotracheal intubation(T3).The incidence and degree of choking,the agitation score,visual analog scale(VAS)score,Ramsay sedation score and the incidence of adverse reactions in the two groups were compared.Results The levels of HR,SBP and DBP at T0,T1,T2 and T3 in the two groups had no significant differences(P>0.05).The levels of catecholamine and IL-6 in the control group were higher than those in the observation group:(120.49±15.13)ng/L vs.(113.53±17.14)ng/L,(16.80±2.61)ng/L vs.(13.46±1.55)ng/L,there were statistical differences(P<0.05).The recovery time to spontaneous breathing in the observation group was shorter than that in the control group:(8.76±2.14)min vs.(9.87±2.09)min,there was statistical difference(P<0.05).The incidence of choking in the observation group was lower than that in the control group:2.17%(1/46)vs.21.74%(10/46),there was statistical difference(P<0.05).The scores of agitation score and VAS in the observation group were lower than that in the control group,and the scores of Ramsay sedation score was higher

关 键 词：麻醉 全身 麻醉前用药 地佐辛 呛咳 

分 类 号：R614.2[医药卫生—麻醉学]