地佐辛对颈丛阻滞下甲状腺手术患者术中应激反应的影响

目的:观察地佐辛对颈丛阻滞下甲状腺手术患者术中应激反应的影响。方法:将ASAⅠ～Ⅱ级行甲状腺手术患者40例随机均分为地佐辛组和对照组。麻醉前5 min,2组分别静脉注射地佐辛0.1 mg/kg和生理盐水,行患侧颈深丛和双侧颈浅丛神经阻滞。记录静脉给药前、切皮、术中及术毕时患者平均动脉压(MAP)、心率(HR)和脉搏氧饱和度(SpO2)值,检测静脉给药前、术中血糖(Glu)和血浆皮质醇(Cor)水平,观察麻醉效果,记录恶心呕吐、眩晕和呼吸抑制的发生率。结果:2组患者MAP和HR在切皮、术中及术毕较麻醉前明显上升(P0.05～P0.01),但地佐辛组低于对照组(P0.05)。术中2组患者Glu和Cor水平均较麻醉前显著升高(P0.01),但地佐辛组均低于对照组(P0.01)。地佐辛组麻醉效果明显优于对照组(P0.05)。2组患者各时点SpO2和术后不良反应发生率差异无统计学意义(P0.05)。结论:地佐辛能够较好地抑制颈丛麻醉下甲状腺手术患者术中应激反应。

Effects of dezocine on stree response in patients undergoing thyroid surgery under cervical plexus block

Objective: To explore effects of dezocine on stress response in patients with thyroid surgery under cervical plexus block. Methods:Forty ASAⅠorⅡpatients scheduled for thyroid surgery by cervical plexus block were randomly divided into dezocine group(group D) and control group(group C).Group D and group C were injected with dezocine 0.1 mg/kg and normal saline,respectively,via vein 5 mins before anesthesia.Then the sick side deep cervical plexus and bilateral superficial cervical plexus were blocked.The mean arterial pressure(MAP),heart rate(HR) and pulse oxygen saturation(SpO2) were recorded just before intravenous injection,onset of skin incision,during operation,and at the end of the surgery.Blood glucose(Glu) and plasma cortisol(Cor) levels were also measured just before intravenous injection and during operation.The effect of anesthesia was evaluated,and the incidence of nausea and vomiting,dizziness and respiratory depression was recorded. Results:MAP and HR significantly increased onset of skin incision,during operation and at the end of surgery(P<0.05-P<0.01) in two groups,but MAP and HR in group D were significantly lower compared with group C(P<0.05).Glu and Cor were significantly increased during operation than that respectively before intravenous injection in two groups(P<0.05),but Glu and Cor in group D were markedly lower compared with group C(P<0.05-P<0.01).The anesthetic effect of group D was better than that of group C(P<0.05).There was no difference in SpO2 at each time point and the incidence of adverse reactions between two groups(P>0.05). Conclusions: Dezocine is effectively capable to inhibit stress response in patients undergoing thyroid surgery under the cervical plexus anesthesia.