喉罩通气条件下地佐辛对腹腔镜胆囊切除术患者疼痛程度和苏醒质量的影响  

The effect of dezocine on pain degree and awakening quality in patients undergoing laparoscopic cholecystectomy under laryngeal mask ventilation

作　　者：郑立山 陶清[1] 张丁[1] 刘芹 黄龙[2] Zheng Lishan;Tao Qing;Zhang Ding;Liu Qin;Huang Long(Department of Anesthesiology,The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei Anhui 230001,China;Department of General Surgery,The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei Anhui China,230001)

机构地区：[1]安徽中医药大学第一附属医院麻醉科,安徽合肥230001 [2]安徽中医药大学第一附属医院普外一科,安徽合肥230001

出　　处：《中国医刊》2025年第2期164-167,共4页Chinese Journal of Medicine

基　　金：安徽省自然科学基金项目(2008085QH389)。

摘　　要：目的分析喉罩通气条件下地佐辛对腹腔镜胆囊切除术(LC)患者疼痛程度和苏醒质量的影响。方法选取2023年1月至2024年5月安徽中医药大学第一附属医院收治的90例LC患者为研究对象,采用随机数字表法分为对照组和研究组,每组45例。对照组给予喉罩通气下全身麻醉,研究组在对照组的基础上于麻醉诱导时给予地佐辛。比较分析两组患者拔除喉罩后1、4、8、12 h的疼痛程度[视觉模拟评分法(VAS)评分]和镇静效果(Ramsay镇静评分)。比较分析两组患者的苏醒质量[自主呼吸恢复时间、苏醒时间、拔除喉罩时间以及拔除喉罩时和拔除喉罩后15、30 min的Steward苏醒评分]、手术前后的应激反应指标[皮质醇(Cor)、去甲肾上腺素(NE)、丙二醛(MDA)]以及围手术期不良反应发生情况。结果拔除喉罩后1、4、8 h,研究组患者的VAS评分均低于对照组,Ramsay评分均高于对照组,差异均有统计学意义(P<0.05);拔除喉罩后12 h,研究组患者的VAS评分低于对照组,差异有统计学意义(P<0.05),而两组患者的Ramsay评分比较差异无统计学意义(P>0.05)。研究组患者的自主呼吸恢复时间、苏醒时间及拔除喉罩时间均短于对照组,差异均有统计学意义(P<0.05);拔除喉罩后15、30 min,研究组患者的Steward评分高于对照组,差异均有统计学意义(P<0.05)。术毕、术后24 h,研究组患者的NE、Cor、MDA水平均低于对照组,差异均有统计学意义(P<0.05)。两组患者围手术期不良反应总发生率比较差异无统计学意义(P>0.05)。结论喉罩通气条件下地佐辛可显著减轻LC患者的疼痛程度,增强镇静效果,提高苏醒质量,减轻应激反应,且安全性较好。Objective To investigate the effects of dezocine on pain degree and awakening quality in patients undergoing laparoscopic cholecystectomy(LC)under laryngeal mask ventilation.Method A total of 90 LC patients admitted to The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from January 2023 to May 2024 were selected as the study objects.They were divided into control group and study group by random number table method,with 45 cases in each group.The control group was given general anesthesia under laryngeal mask ventilation,and the study group was given dezocine during anesthesia induction on the basis of the control group.The pain degree(VAS score)and sedation effect(Ramsay sedation score)at 1,4,8 and 12 h after laryngeal mask removal were compared between the two groups.The awakening quality(recovery time of spontaneous breathing,awakening time,laryngeal mask removal time,Steward score at laryngeal mask removal and 15,30 min after laryngeal mask removal),stress response indexes(Cor,NE,MDA)before and after surgery,and perioperative adverse reactions were compared between the two groups.Result At 1,4 and 8 h after laryngeal mask removal,VAS scores in study group were lower than those in control group,Ramsay scores were higher than those in control group,with statistical significance(P<0.05).At 12 h after laryngeal mask removal,the VAS score in study group was lower than that in control group,with statistical significance(P<0.05),while there was no statistically significant difference in Ramsay score between the two groups(P>0.05).The recovery time of spontaneous respiration,awakening time and laryngeal mask removal time in study group were shorter than those in control group,with statistical significance(P<0.05).The Steward scores at 15 and 30 min after laryngeal mask removal in study group were higher than those in control group,with statistical significance(P<0.05).After surgery and 24 h after surgery,the levels of NE,Cor and MDA in study group were lower than those in control group,w

关 键 词：喉罩通气 腹腔镜胆囊切除术 地佐辛 疼痛 苏醒质量 

分 类 号：R614[医药卫生—麻醉学]