地佐辛在喉罩置入全麻诱导中的应用

目的：观察不同剂量地佐辛用于妇科腹腔镜手术喉罩置入全麻诱导的安全性与有效性。方法：拟全麻下行择期妇科腹腔镜手术患者80例，随机分为不同剂量地佐辛组（D1、D2、D3组）和芬太尼组（F组），分别在静脉注射丙泊酚前5分钟给予地佐辛0.1 mg/kg、0.15 mg/kg、0.2 mg/kg和芬太尼3μg/kg，观察诱导前、喉罩置入前、喉罩置入即刻及喉罩置入后1、3、5 min心率（HR）和血压（MAP）的变化。结果：D1组在喉罩置入时及置入后1、3 min的MAP和HR明显高于F组（P＜0.05），D2组和D3组在各时点MAP和HR与F组比较无明显差异（P＞0.05）。结论：地佐辛用于妇科腹腔镜手术喉罩置入全麻诱导，能够有效维持诱导期间血流动力学稳定，其适宜剂量推荐为0.1 mg/kg。

Clinical Effect of Dezocine during Induction and Laryngeal Mask Airway under General Anesthesia

Objective To observe the clinical efficacy and safety of differert doses of dezocine during in-duction and Laryngeal Mask Airway （LMA） under general anesthesia in the gynecological laparoscopy operation. Methods Eighty patients scheduled for gynecological laparoscopy operation were divided into four groups ran-domly（n=20）. Induction was performed following induction with dezocine 0.1 mg/kg, propofol 2 mg/kg and ro-curonium 0.6 mg/kg in group D1. In group D2, dezocine were used with 0.1 mg/kg, propofol 2 mg/kg and ro-curonium 0.6 mg/kg.In group D3, dezocine were used with 0.15 mg/kg, propofol 2 mg/kg and rocuronium0.6mg/kg. Fentanyl 3 μg/kg, propofol 2 mg/kg and rocuronium 0.6 mg/kg were used in group F. The changes of MAP and HR were recorded at preinduction、preinsertion LMA、insertion LMA and post-insertion LMA 1, 3, 5 min-utes. Results MAP and HR after insertion LMA were higher at T3 and T4 in group D1 than in group F, but no differences in groups D2 and D3. Conclusion The results suggest that dezocine can be used during induction and Laryngeal Mask insertion for general anesthesia. Dezocine 0.1 mg/kg would provide a stable hemodynamic state and restrain cardiovascular reflection of laryngeal mask insertion for gynecological laparoscopy operation.