地佐辛对预防腹腔镜胆囊切除术全麻苏醒期躁动的观察

目的:观察地佐辛对预防腹腔镜胆囊切除术(LC)全麻苏醒期躁动的有效性和安全性。方法:择期在全麻下行LC患者90例(ASAⅠ~Ⅱ级)随机分为Ⅰ~Ⅲ组,依次分别于手术结束前30 min静注NS 2 mL、氯诺昔康0.2 mg/kg、地佐辛0.1 mg/kg(每组30例)。记录3组麻醉前(T1)、拔管时(T2)、拔管后5 min(T3)的HR和平均动脉压(MAP),T2的躁动评分、T3的Ramsay镇静和疼痛评分以及从手术结束至拔管的时间。结果:3组T2的HR和MAP均较T1明显升高(P<0.05);Ⅰ组T3的HR和MAP较T1明显升高(P<0.05),Ⅱ、Ⅲ组比无统计学意义。Ⅱ、Ⅲ组T2、T3的HR和MAP均明显低于Ⅰ组(P<0.05);Ⅲ组T2、T3的HR和MAP与Ⅱ组比无统计学意义。Ⅱ、Ⅲ组T2的躁动评分明显低于Ⅰ组(P<0.05),Ⅱ和Ⅲ组比无统计学意义。Ⅱ、Ⅲ组T3的镇静和疼痛评分明显优于Ⅰ组(P<0.05);Ⅲ组镇静评分明显优于Ⅱ组(P<0.05),Ⅱ、Ⅲ组疼痛评分比无统计学意义。3组从手术结束至拔管时间比无统计学意义。结论:地佐辛能有效、安全地预防LC全麻苏醒期躁动。

Observation of Dezocine on Prevention of Emergence Agitation in Patients Undergoing Laparoscopic Cholecystectomy

Objective: To observe the efficacy and safe of dezocine on prevention of emergence agitation in patients undergoing laparoscopic cholecystectomy(LC).Methods: Ninety patients(ASA Ⅰ～Ⅱ grade)undergoing LC under general anesthesia were ramdonly divided into Group Ⅰ～Ⅲ with 30 cases in each group,which were given respectively normal saline 2 mL,lornoxicam 0.2 mg/kg and dezocine 0.1 mg/kg iv.30 minutes before operations ended.Heart rate(HR)and the mean arterial pressure(MAP)before anesthesia(T1),endotracheal extubation(T2)and 5 minutes after extubation(T3)were recorded.Agitation score at T2,the Ramsay sedation score and the VAS pain score at T3 were observed.Duration from the end of the operation to the extubation was also recorded.Results: HR and MAP obviously raised at T2 among groups(P<0.05),which were also increased markedly at T3 in Group Ⅰ(P<0.05)but not in Group Ⅱ and Ⅲ.HR and MAP at T2 and T3 in Group Ⅱ and Ⅲ were obviously lower than those in Group Ⅰ(P<0.05),which had no difference between Group Ⅱ and Ⅲ.Agitation score at T2 was significantly lower in Group Ⅱ and Ⅲ than in Group Ⅰ(P<0.05)but had no difference between Group Ⅱ and Ⅲ.Sedation and pain scores at T3 were obviously better in Group Ⅱ and Group Ⅲ than in Group Ⅰ(P<0.05).Sedation score was better in Group Ⅲ than in Group Ⅱ(P<0.05)and the pain score between Group Ⅱ and Ⅲ had no difference.Duration from the end of operation to extubation had no statistic differences among groups.Conclusion: Dezocine can effectively and safely prevent emergence agitation in patients undergoing LC.