麻醉诱导应用地佐辛对甲状腺手术患者术后疼痛程度的影响

目的：评价甲状腺手术麻醉应用地佐辛诱导对患者术后疼痛程度的影响，并探讨其对甲状腺手术患者术后镇痛效果的影响。方法选择ASAⅠ～Ⅱ级，拟行甲状腺择期手术患者40例，年龄30～64周岁，性别不限，体重45～75kg，随机分为地佐辛组（D组）和芬太尼组（F组）（n＝20）。D组静脉注射咪达唑仑0．06mg/kg、地佐辛0．1mg/kg、丙泊酚1．5～2．0mg/kg和维库溴铵0．1mg/kg诱导，F组注射咪达唑仑0．06mg/kg、芬太尼3μg/kg、丙泊酚1．5～2．0mg/kg和维库溴铵0．1mg/kg诱导。两组均采用全凭静脉维持麻醉。于麻醉诱导前、插管即刻、手术开始即刻、手术结束即刻和拔管后10min时记录患者的收缩压、舒张压和心率，以及术后10min、30min、1h、2h、4h、6h的疼痛VAS评分和不良反应的发生情况。结果两组患者各时间点血流动力学指标均在正常范围。与F组比较，D组术后VAS评分明显降低（P＜0．05）。结论行甲状腺手术的患者，全麻诱导应用地佐辛可显著减轻患者的术后疼痛程度。地佐辛麻醉诱导对甲状腺手术患者安全有效，术后镇痛效果可靠。

Effects of using dezocine for induction of anesthesia on degree of pain in patients after thyroid gland ;surgery

Objective To evaluate the effects of using dezocine for induction of anesthesia on degree of pain in patients after thyroid gland surgery ,and to investigate the effects on the efficacy of postoperative analgesia in patients of thyroid gland surgery.Methods Forty ASAⅠorⅡpatients of both sexes, aged 30-64yr, weighing 45-75kg, undergoing elective thyroid gland surgery , were randomly divided into 2 groups （ n =20each ） ：dezocine （D） group and fentanyl （F） group.Anesthesia was induced with iv injection of midazolam 0.06mg/kg, dezocine 0.1mg/kg, propofol 1.5-2.0mg/kg and vecuronium 0.1mg/kg in group D or with midazolam 0.06mg/kg, fentanyl 3μg/kg, propofol 1.5 -2.0mg/kg and vecuronium 0.1mg/kg in group F.In the two groups, anesthesia were maintained with total intravenous anesthesia .The systolic pressure , diastolic pressure , heart rate were recorded before induction of anesthesia , the beginning of endotracheal intubation , the beginning of surgery , the end of surgery and 10 min after extubation , and VAS scores of patients , the side effects were recorded at 10min,30min,1h,2h,4h,6h after surgery.Results In both groups, the hemodynamic parameters were within the normal range at each time point .Compared with group F , VAS scores were significantly lower in group D （ P〈0.05）.Conclusions The degree of pain is reduced in patients after thyroid gland surgery using dezocine for induction of anesthesia .Dezocine can be safely and effectively used for induction of anesthesia in patients of thyroid gland surgery , and the efficacy of postoperative analgesia was reliable .