地佐辛不同给药方式对瑞芬太尼复合麻醉术后苏醒期拔管及镇痛镇静效果的影响

目的 探讨地佐辛不同给药方式对瑞芬太尼复合麻醉术后苏醒期拔管及镇痛镇静效果的影响.方法 选择在我院行腹腔镜胆囊切除术的患者为研究对象,所有患者均常规给予瑞芬太尼复合麻醉.随机分为地佐辛肌注组和地佐辛静注组,分别于手术结束前30 min给予地佐辛0.2 mg/kg肌肉注射或静脉注射.同时,选择以往采用芬太尼术后镇痛的腹腔镜胆囊切除术患者为对照组,于手术结束前15 min给予芬太尼1μg/kg静脉注射.对比分析三组患者术后苏醒时间、气管导管拔管时间、镇痛镇静效果以及不良反应发生情况.结果 肌注地佐辛组患者平均苏醒时间及气管导管拔管时间均明显短于静注地佐辛组（t=3.207,P=0.002;t=2.454,P=0.014）和对照组（t=5.591,P=0.000;t=6.778,P=0.000）;静注地佐辛组也明显短于对照组（t=2.128,P=0.035;t=3.706,P=0.000）.苏醒时对照组VAS平均评分略低于肌注地佐辛组和静注地佐辛组（t=1.920,P=0.056;t =0.000,P=1.000）,静注地佐辛组与肌注地佐辛组间差异无统计学意义（t=1.854,P=0.065）.对照组SAS平均评分明显高于肌注地佐辛组和静注地佐辛组（t=12.855,P=0.000;t=8.035,P=0.000）,而静注地佐辛组也明显高于肌注地佐辛组（t=4.450,P=0.000）.苏醒后1h对照组VAS平均评分略高于肌注地佐辛组和静注地佐辛组（t=1.882,P=0.060;t=1.218,P=0.223）,静注地佐辛组略高于肌注地佐辛组（t=0.871,P=0.385）.对照组SAS平均评分亦明显高于肌注地佐辛组和静注地佐辛组（t=9.650,P=0.000;t=5.531,P=0.000）,而静注地佐辛组亦明显高于肌注地佐辛组（t=3.413,P=0.001）.苏醒后2h对照组VAS平均评分略高于静注地佐辛组（t=1.388,P=0.165）,明显高于肌注地佐辛组（t=3.416,P=0.001）,静注地佐辛组亦高于肌注地佐辛组（t=2.275,P=0.024）.肌注地佐辛组SAS平均评分明显低于静注地佐辛组和对照组（t=7.963,P =0.000;t =8.271,P=0.000）,而静注地佐辛组和?

Influence on decannulation and sedation analgesia after postoperative recovery using remifentanil combined anesthesia with different ways of dezocine delivery

Objective To investigate the influence on decannulation and sedation analgesia after postoperative recovery using remifentanil combined anesthesia with different ways of dezocine delivery. Methods Patients treated with laparoscopic cholecystectomy of our hospital were selected as the research object, all patients were conventionally given remifentanil combined anesthesia. They were randomly divided into dezocine intramuscular injection group and dezocine intravenous injection group. All the patients were given dezocine 0. 2 mg/kg,intramuscular injection or dezo- cine intravenous injection for 30 min before the end of surgery. Meanwhile,laparoscopic cholecystectomy patients who were given fentanyl for postoperative analgesia were selected as the control group, they were given fentanyl 1 μg/kg, intravenous injection for 15 min before the end of surgery. The postoperative palinesthesia time, trachea extubation time, analgesia calming effects and adverse reactions of the three groups were contrastively analyzed. Results The av- erage recovery time and trachea extubation time of dezocine intramuscular injection group were significantly shorter than those of the dezocine intravenous injection group （ t = 3. 207, P = 0. 002; t = 2. 454, P = 0. 014 ） and the control group（ t = 5. 591, P = 0. 000 ; t = 6. 778, P = 0. 000）. The dezocine intravenous injection group were significantly shorter than the control group （ t = 2. 128, P = 0. 035 ; t = 3. 706, P = 0. 000 ）. When the patients made a palinesthesia, the average VAS score of the control group were slightly lower than the dezocine intramuscular injection group and dezocine intravenous injection group （ t = 1. 920, P = 0. 056 ; t = 0. 000, P = 1. 000 ） , there was no statistically significant difference between the dezocine intramuscular injection group and dezocine intravenous injection group （ t = 1. 854, P = 0. 065 ）.The average SAS score of the control group were significantly higher than the dezocine intramuscular injection group and dezocine in