地佐辛与瑞芬太尼用于腹腔镜结直肠癌根治手术镇静、镇痛效果比较

目的：比较地佐辛与瑞芬太尼用于腹腔镜结直肠癌根治手术的镇静、镇痛效果。方法：70例行腹腔镜结直肠癌根治术治疗的患者根据受试者筛选入组顺序随机分为2组，地佐辛组（n=35例）麻醉维持采用地佐辛（1~3 μg·kg^-1·min^-1），瑞芬太尼组（n=35例）麻醉维持采用瑞芬太尼（0.1~0.3 μg·kg^-1·min^-1）。比较两组患者不同时间点平均动脉压（MAP）、心率（HR）及视觉模拟评分（VAS）、布氏舒适评分（BCS）和镇静/躁动评分（SAS）变化，比较两组患者苏醒时间、气管导管拔除时间、离开PACU时间及不良反应发生率。结果：两组手术开始即刻和术毕时的MAP、HR均明显低于麻醉时，且瑞芬太尼组下降较地佐辛组更为显著（P<0.05）；地佐辛组苏醒时间、气管导管拔除时间及离开PACU时间均明显长于瑞芬太尼组（P<0.05）；地佐辛组苏醒后不同时间点VAS及SAS评分均明显低于瑞芬太尼组（P<0.05），而BCS评分明显高于瑞芬太尼组（P<0.05）；两组患者肝肾功能指标及不良反应发生率比较无显著差异性（P>0.05）。结论：腹腔镜结直肠癌根治手术麻醉维持使用地佐辛镇痛效果明显优于瑞芬太尼，且血流动力学更为平稳。

Sedative and analgesic effects of dezocine and remifentanil in laparoscopic colorectal cancer radical surgery

OBJECTIVE To compare sedative and analgesic effects of dezocine and remifentanil in laparoscopic colorectal cancer radical surgery.METHODS Seventy patients treated with laparoscopic colorectal cancer radical surgery were randomly divided into 2 groups in screening sequence.Patients received dezocine (1-3 μg·kg^-1·min^-1) to maintain anesthesia in dezocine group (n=35 cases),remifentanil (0.1-0.3 μg·kg^-1·min^-1) in remifentanil group (n=35 cases).MAP,HR and VAS,BCS,SAS were compared between two groups at different time points.Waking time,tracheal catheter removal time,time to leave PACU and incidence of adverse reactions were compared between two groups.RESULTS MAP and HR at start and end of operation were significantly lower than that during anesthesia in both groups,particularly in remifentanil group (P<0.05).Waking time,removal time of tracheal catheter and time to leave PACU were significantly longer in dezocine group than in remifentanil group (P<0.05).VAS and SAS scores at different time points after waking up in dezocine group were significantly lower than those in remifentanil group (P<0.05),while BCS score was significantly higher than that in remifentanil group (P<0.05).Incidences of adverse reactions,hepatic and renal functions showed no significant difference between two groups (P>0.05).CONCLUSION Dezocine has superior sedative and analgesic effects to fentanyl for maintaining anesthesia in laparoscopic colorectal cancer radical surgery,with more smoothly hemodynamics.