不同剂量地佐辛复合七氟醚对上腹部手术患者麻醉效果及血流动力学的影响

目的探讨不同剂量地佐辛复合七氟醚对上腹部手术患者麻醉效果及血流动力学的影响。方法选择2013年1月至2015年1月择期上腹部手术的患者60例,随机分为3组,每组20例。所有患者采用七氟醚进行麻醉维持,A组患者给予0.1 mg/kg地佐辛,B组患者给予0.2 mg/kg地佐辛,C组患者给予等量生理盐水。观察患者术中的血流动力学指标的变化情况,同时记录患者的拔管时间、苏醒时间、术后的镇静评价和不良发应发生情况。结果 T_1时三组患者的SBP、DBP显著降低,且B组HR低于A组、C组,而C组SBP、DBP低于A组、B组,差异均有统计学意义(P<0.05);T_2时A组的HR、SBP、DBP均高于T_1时,而B组、C组患者的HR、SBP较T_1时升高,差异均有统计学意义(P<0.05);T_3时A组、C组HR较T_2时降低,SBP、DBP升高,B组HR降低,差异均有统计学意义(P<0.05),同时B组相应指标均低于A组、C组,差异有统计学意义(P<0.05);T_4时A组、C组SBP、DBP降低(P<0.05),三组患者的SpO_2比较差异无统计学意义(P>0.05)。B组患者术后1 h的OAAS评分高于A组、C组,差异有统计学意义(P<0.05)。A组七氟醚平均吸入浓度为4.02%±0.98%,B组为3.96%±1.01%,C组为3.98%±0.84%,三组比较差异无统计学意义(P>0.05)。三组患者的不良反应发生率比较差异无统计学意义(P>0.05)。结论在七氟醚麻醉中复合0.2 mg/kg地佐辛,患者的血流动力学指标较稳定,术后镇静效果较好,全身麻醉中的应激反应较少,具有较高的安全性。

Effects of different doses of dezocine combined with sevoflurane on the anesthesiolo-gy and hemodynamics of patients undergoing upper abdominal surgery

Objective To investigate the effect of different doses of dezocine combined with sevoflurane on anesthesiology and hemodynamics of patients undergoing upper abdominal surgery. Methods Sixty patients receiving elective upper abdominal surgery from January 2013 to January 2015 were randomly divided into 3 groups. The anesthe-sia of all patients was maintained with sevoflurane,at the same time,group A (n=20) was given 0. 1 mg/kg dezo-cine,group B (n=20) was given 0. 2 mg/kg dezocine,and group C was given the same amount of physiological sa-line. The changes of hemodynamics were observed,and the extubation time,recovery time,postoperative sedation as-sessment and the adverse reaction were recorded. Results The SBP and DBP of all patients decreased at T1 ( P <0. 05),and the HR in group B was lower than that of group A and group C (P<0. 05),while the SBP and DBP of group C were lower than those of group A and group B (P<0. 05);the HR,SBP and DBP of group A at T2 were high-er than those at T1(P<0. 05),and the HR and SBP in group B and group C were also higher (P<0. 05);the HR of group A and group C at T3 decreased significantly than that at T2,while SBP and DBP increased (P<0. 05),the HR in group B decreased (P<0. 05),and the indexes in group B were lower than that of group A and group C (P<0. 05);the SBP and DBP of group A and group C decreased significantly at T4(P<0. 05),and there was no significant differ-ence in SpO2 among the 3 groups (P>0. 05). The OAAS score in group B was higher than those of group A and group C (P<0. 05). The average inhalation concentration of sevoflurane was 4. 02% ± 0. 98%,3. 96% ± 1. 01% and 3. 98%± 0. 84% in group A,group B and group C;no significant difference was found in the average inhalation concentration of sevoflurane and the adverse reaction rate among the 3 groups (P>0. 05). Conclusion Sevoflurane anesthesia com-bined with 0. 2 mg/kg dezocine has more stable hemodynamics and better postoperative sedative effect;besides,it can reduce the stress response of general anesthesia with high safety.