地佐辛辅助腰硬联合麻醉时对二氧化碳通气反应的影响

Effects of Dezocine on ventilatory response to carbon dioxide in combined-epidural labor analgesia

目的:观察地佐辛辅助腰硬联合麻醉对二氧化碳通气反应的影响。方法:选20例择期腹部手术患者,于腰硬联合麻醉前后及辅助静注地佐辛5mg后5min分别观测患者的呼吸频率(RR)、潮气量(VT)、脉搏氧饱和度(SpO2),呼气末二氧化碳分压,并记录地佐辛使用前后5min患者吸入二氧化碳的通气反应。结果:在腰硬联合麻醉及地佐辛使用前后,患者的SpO2、RR及呼气末二氧化碳分压均无明显改变。潮气量在腰硬联合麻醉前后无明显改变,但在地佐辛使用后5min明显下降(P<0.01)。二氧化碳通气反应曲线的斜率未见明显改变。结论:地佐辛辅助腰硬联合麻醉对患者的VT有一定影响,但对呼吸中枢的抑制作用较轻。

Objective： To investigate the effect of Dezocine on ventilatory response to carbon dioxide in combined spinal epidural analgesia （CSEA）. Methods： Twenty patients undergoing abdominal surgery were given Dezocine 5 mg, to observe the patient＇s respiratory frequency （RR）, tidal volume-the （VT）, pulse oxygen saturation （SpO2）, breathe out carbon dioxide points at the end of the pressure before and after CSEA and 5 minutes after Dezocine injection. And to record ventilatory response of carbon dioxide in 5 min before and after Dezocine injection. Results： End-tidal concentration of CO2, RR and pulse oxygen saturation did not change significantly after spinal block and Dezocine. There was no significant change in VT after spinal block compared with the baseline value but VT decreased significantly after Dezocine （P〈0.01）. There was no significant change in the slope of CO2 ventilatory response curve before and after Dezocine but VT at different end-tidal concentration of CO2 decreased significantly 5 min after Dezocine. Conclusion： Dezocine given after spinal block decreases VT but depression of respiratory center is slight and lasts for short period of time.