地佐辛对丙泊酚复合瑞芬太尼麻醉下食管癌根治术患者苏醒期躁动的影响

目的探讨地佐辛防治丙泊酚复合瑞芬太尼全麻下食管癌根治术患者术后躁动的有效性与安全性。方法 60例行食管癌根治术患者随机均分为生理盐水组(N组)和地佐辛组(D组)。持续静脉输注丙泊酚和瑞芬太尼并间断静脉注射维库溴铵维持麻醉,2组分别于手术结束前1 h静脉注射生理盐水1 ml和地佐辛5 mg。观察苏醒期的躁动情况,记录自主呼吸恢复及拔管时间,拔管即刻(T1)、拔管后30 min(T2)和60 min(T3)时平均动脉压(MAP)、心率(HR)和脉搏氧饱和度(SpO2),VAS、Ramsay评分以及恶心、呕吐和眩晕的发生率。结果 D组术后躁动发生率和躁动程度以及MAP、HR(T1、T2)、VAS评分(T1～T3)和Ramsay评分(T1、T2)显著低于N组(P0.01);2组自主呼吸恢复和拔管时间、SpO2和不良反应发生率差异无统计学意义(P0.05)。结论地佐辛能安全有效地预防丙泊酚复合瑞芬太尼全麻下食管癌根治术患者术后躁动的发生。

The effects of dezocine on the emergence agitation in patients subjected radical operation for esophageal cancer after propofol-remifentanil anesthesia

Objective To explore the efficacy and safety of dezocine to prevent the postoperative agitation in patients sustained radical operation for esophageal cancer under propofol-remifentanil anesthesia.Methods 60 patients scheduled for esophageal cancer resection were randomly divided into normal saline group（N group） and dezocine group（D group） equally.Propofol and remifentanil were infused continuously via vein with intermittent administration of vecuronium to maintain anesthesia after tracheal intubation.Normal saline 1 ml and dezocine 5 mg was infused respectively 1 h before surgery would end in each group.The incidence and the degree of postoperative agitation,the time of resumption of spontaneous respiration and extubation were recorded.The heart rate（HR）,mean arterial blood pressure（MAP）,saturation of pulse oxygen（SpO₂） and the scores of VAS and Ramsay were recorded at the time just after extubation（T1）,30 min（T2） and 60 min（T3） after extubation,and the incidence of nausea,vomiting and dizziness were recorded as well.Results Compared with group N,the incidence and the level of agitation,MAP and HR（T1,T2）,and scores of VAS（T1^T3） and Ramsay（T1,T2） in group D were significantly lower（P<0.01）.There was no difference in the time of spontaneous respiration recovery and extubation,SpO₂ and the incidence of adverse reactions between two groups（P>0.05）.Conclusion Dezocine is capable to prevent the emergence agitation in patients subjected radical operation for esophageal cancer under propofol-remifentanil anesthesia safely and effectively.