地佐辛诱导对苏芬太尼麻醉苏醒期患者躁动的影响

目的 观察地佐辛诱导预防苏芬太尼麻醉苏醒期患者躁动的作用.方法 选择60例ASA Ⅰ～Ⅱ级上腹部手术患者,随机分为3组,每组均为20例,麻醉诱导均用咪哒唑仑0.05 mg/kg,异丙酚1～2mg/kg,维库溴铵0.12 mg/kg.镇痛药3组分别为:苏芬太尼组1μg/kg,芬太尼组4μg/kg,地佐辛组0.2 mg/kg.维持麻醉均用苏芬太尼、异丙酚.记录麻醉苏醒期3组患者镇痛评分( VAS)、躁动评分(RS),拔管时间和不良反应.结果 与苏芬太尼对比,芬太尼组、地佐辛组在麻醉苏醒期间,患者的血流动力学更平稳,与芬太尼组对比地佐辛组在麻醉苏醒期间Ramsay评分、VAS评分、RS评分更低,更安静(躁动减少)、呼吸抑制、呕吐、皮肤瘙痒等不良反应少(P＜0.05),拔管时间差异有统计学意义(P＜0.05).结论 0.2 mg/kg地佐辛用于全麻诱导麻醉苏醒期较芬太尼减少患者躁动,呼吸抑制、呕吐等不良反应发生率降低.

Effects of the induction with Dezocine on incidence of the postoperative agitations of the patients during recovery period after remifentanil anesthesia

Objective To investigate the effects of induction with Dezocine to prevent the agitation of the patient after remifentanil anesthesia. Methods 60 patients of upper abdominal surgery, ASA I - II class, were randomly divided into 3 groups,20 patients in each group, anesthesia was induced with the midazolam 0.05mg/kg, propofol 1- 2mg/kg, vecuronium 0.12mg/kg. Analgesic drugs were administer as follow： control group, remifentanil （ group Rmf） 1μg/kg; fentanyl group （ group F ） 4 μg/kg; Dezocine group （ group D ） 0.2mg/kg. Remifentanil, propofol are used to maintain anesthesia. The time of recovery and extubation,the VAS pain score, the Ramsay score and adverse reactions such as vomiting,respiratory depression after extubation were recorded. Results Compared with group Rmf, the hemodynamic parameters was more stable in group F and group D. Compared with group F （ 1μg/kg）, the VAS pain score, the Ramsay score and adverse reactions significantly decreased in group D（ P 〈 0.05）, and the time of extuba- tion in group F was longer than group D（P 〈0.05）. Conclusion 0. 2mg/kg of Dezocine could be used for the induction of anesthesia to reduce the incidence of agitation and adverse reactions during recovery period.