地佐辛对瑞芬太尼复合七氟醚麻醉苏醒期躁动的影响

Effects of dezocine on the agitations after remifentanil-sevoflurane anaesthesia

目的:观察地佐辛对瑞芬太尼复合七氟醚麻醉苏醒期躁动的影响。方法:选择拟行腹腔镜子宫全切除术的患者80例,ASAⅠ～Ⅱ级,年龄46～65岁,随机分为实验组(n=40)和对照组(n=40)。实验组手术结束前20 min给予地佐辛5 mg静脉注射,对照组手术结束前20 min给予生理盐水1 ml静脉注射。记录患者手术结束时、拔管时和拔管后5 min的心率(HR)、平均动脉压(MAP),拔管时的躁动评分、拔管后5 min的镇静评分(Ramsay)及从手术结束至拔管的时间。结果:两组患者在手术结束时HR和MAP无明显差异(P>0.05);C组拔管时和拔管后5 min的HR、MAP较手术结束前显著升高(P<0.05);E组拔管时的HR、MAP较手术结束前显著升高(P<0.05),拔管后5 min的HR、MAP较手术结束时无显著差异(P>0.05),E组患者HR、MAP在拔管时和拔管后5 min均高于C组(P<0.05)。E组拔管时的躁动评分低于C组(P<0.05),拔管后5 min的镇静评分高于C组(P<0.05)。术后拔管时间两组患者无明显统计学差异(P>0.05)。结论:地佐辛可以有效抑制瑞芬太尼复合七氟醚麻醉苏醒期的拔管反应和躁动。

Objective：To observe the effects of dezocine on the agitations after remifentanil-sevoflurane anaesthesia.Methods：Eighty ASAⅠorⅡ grade patients who were scheduled for total hysterectomy under laparoscopy,aged from 46 to 65 years,were randomly divided into experimental group（group E,n=40） and control group（group C,n=40）.Patients in group E were administered with 10 mg dezocine and in group C with 2 ml normal saline at 20 min before the end of the operations.Heart rate（HR） and the mean arterial pressure（MAP） at the end of the operations,endotracheal extubation and 5 min after endotracheal extubation were recorded.Agitation score during endotracheal extubation and the Ramsay sedation score 5 min later were observed.Duration from the end of the operation to the extubation was also recorded.Results：HR and MAP at the end of the operations had no significant differences between two groups（P 0.05）,but they raised markedly in group C at extubation and 5 min later（P 0.05）.They were also obviously increased in group E at extubation（P 0.05）,but had no significant differences 5 min later（P 0.05）.There were remarkably differences in HR and MAP at extubation and 5 min later between group E and group C（P 0.05）.Agitation score was lower in group E than in group C during extubation（P 0.05）.Ramsay sedation score was higher in group E than in group C 5 min after extubation（P 0.05）.Duration from the end of operation to extubation had no statistic differences between the two groups（P 0.05）.Conclusion：Dezocine can effectively alleviate the agitations after remifentanil-sevoflurane anaesthesia.