地佐辛用于预防鼻内窥镜手术全麻苏醒期躁动的临床观察

目的 评价术毕前静脉注射地佐辛对鼻内窥镜手术全麻苏醒期躁动（EA）的影响.方法 选取择期全麻下行鼻内窥镜手术患者120例,随机数字法分为芬太尼（F）组和地佐辛（D）组以及对照试验组（S）,每组各40例.所有患者均采用丙泊酚加瑞芬太尼全凭静脉麻醉,间断注射维库溴铵维持肌松.常规监测心电图（ECG）、无创血压（BP）、心率（HR）、血氧饱和度（SpO2）、呼气末二氧化碳分压（PETCO2）,在手术结束前30 min于F组静脉注射芬太尼1 μg/kg,D组静脉注射地佐辛10 μg/kg,S组静脉注射2 ml生理盐水.分别记录自主呼吸恢复时间、苏醒时间、拔管时间、拔管时的镇静-躁动（RASS）评分,拔管5 min后的呼吸频率及拔管30 min后的视觉模拟疼痛（VAS）评分.结果 三组患者中F组和D组自主呼吸恢复时间、苏醒时间和拔管时间差异无统计学意义（P＞0.05）,S组自主呼吸恢复时间、苏醒时间和拔管时间明显长于D组和F组.苏醒期RASS评分、VAS评分,D组略优于F组,明显优于S组,差异具有统计学意义（P＜0.05）.结论 在鼻内窥镜全麻手术结束前30 min静脉注射地佐辛10 μg/kg对预防EA有一定的效果.

Clinical observation of the dezocine application to prevent emergence agitation of general anesthesia in nasal endoscopic surgery

Objective To evaluate the impact of dezocine intravenous administration before the nasal endoscopic surgery finished in general anesthesia emergence agitation （EA）. Methods Selected 120 cases of patients who had nasal endoscopic surgery under general anesthesia, random numbers method were used to divide them into fentanyl （F） group and the dezocine （D） group and control experiment group （S）, 40 cases in each group. All patients were using propofol combined with remifentanyl by intravenous anesthesia, intermittent injection of vecuronium bromide to maintain muscle relaxant. Regular monitoring of the electrocardiogram （EGG）, noninvasive blood pressure （BP）, heart rate （HR）, blood oxygen saturation （ SpO2 ）, partial pressure of carbon dioxide in endexpiratory gas （ PETCO2 ） ; 30 minutes before the end of the surgery, group F had intra- venous infusion of fentanyl 1 μg/kg, group D had intravenous infusion of dezocine 10 p~g/kg, group S had intravenous infusion of 2 ml saline. Record the restore time of spontaneous breathing, awakening time, extubation time, sedation-agitation （RASS） score during extubation, the breathing frequency of 5 minutes after extubation and visual analog pain score （VAS） of 30 minutes after extubation. Results In the three groups of patients, group F and group D did not have significant differences in restore time of spontaneous breathing, the awakening time and extubation time （P 〉 0. 05）, the restore time of spontaneous breathing, the awakening time and extubation time in group S were significantly longer than that in group D and group F. In RASS score and VAS score in awakening period, group D was slightly better than group F, and significantly better than that group S with statistical significance （P 〈 0. 05 ）. Conclusion 30 minutes before the end of the nasal endoscopic surgery in general anesthesia, the intravenous infusion of dezocine at 10 μg/kg had certain effect for preventing emergence agitation （EA）.