地佐辛注射液对腹腔镜胆囊切除术全麻苏醒期不良反应的影响

目的:探讨地佐辛注射液对腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)病人全麻苏醒期不良反应的影响。方法:选择90例择期行腹腔镜胆囊切除术患者,随机均分为3组:地佐辛组(男16例,女14例)、芬太尼组(男15例,女15例)、曲马多组(男17例,女13例)。术毕关气腹前各组分别以地佐辛0.1mg/kg,芬太尼0.002mg/kg,曲马多2mg/kg静脉注射镇痛。3组病人均用咪达唑仑+异丙酚+舒芬太尼+顺式阿曲库铵静脉诱导后行气管插管,术中以吸入七氟醚和持续静注异丙酚麻醉。观察并记录各组24h内视觉模拟疼痛(VAS)评分、Ramsay镇静评分及不良反应发生例数。结果:地佐辛组和芬太尼组在0.5、1、4h观察时段VAS评分明显低于曲马多组,差异均有统计学意义(P<0.05),12、24h各观察时段3组VAS评分差异无统计学意义;地佐辛组在0.5、1h观察时段Ramsay镇静评分显著高于芬太尼组和曲马多组(P<0.05),3组病例4、12和24h各观察时段Ram-say镇静评分差异无统计学意义(P<0.05);地佐辛组无恶心、呕吐,芬太尼组恶心4例、呕吐0例,曲马多组恶心14例、呕吐7例。结论:地佐辛静脉注射对全麻苏醒期不良反应有良好的治疗效果,用于腹腔镜胆囊切除术病人安全有效。

Influence of dezocine injection to the side effects during tracheal extubation period in laparoscopic cholecystectomy

AIM: To explore the effect of dezocine injection to the side effects during tracheal extubation period in laparoscopic cholecystectomy METHODS: 90 patients treated with laparoscopic cholecystectomy were divided into three groups randomly,the dezocine group,including 16 men and 14 women,were injected with dezocine 0.1 mg/kg,and the fentany group(15 men and 15 women) were injected with fentanyl 0.002 mg/kg,and the tramadol group,including 17 men and 13 women,were injected with tramadol 2 mg/kg when the surgery was over.After venous induction with midazolam,propofol and cisatracurium to endotracheal intubation,the patients inhalated sevoflurane and injected propofol continuously during operation.The VAS analgesic score,Ramsay sedative score and the side reaction between the three groups were observed and recorded within 24 h after operation.RESULTS:The VAS scores of the dezocine group and the fentany group were much lower than those of the tramadol group at 0.5,1,4 h after operation,there was statistical significance(P<0.05).The VAS scores at 12,24 h in three groups had no statistical significance.The Ramsay sedative scores of the dezocine group were much higher than those of the fentany group and the tramadol group at 0.5,1 h after operation(P<0.05),The Ramsay sedative scores at 4,12,24 h in three groups had no statistical significance(P<0.05).There were no nausea and vomiting in dezocine group,4 nausea and 0 vomiting in fentany group,and 14 nausea and 7 vomiting in tramadol group.CONCLUSION: Injecting the dezocine 0.1 mg/kg in vein is effective and safe when using in laparoscopic cholecystectomy.