地佐辛注射液对腹腔镜胆囊切除术全麻苏醒期不良反应的影响

Influence of dezocine injection to the side effects during tracheal extubation period in laparoscopic cholecystectomy

目的:探讨地佐辛注射液对腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)病人全麻苏醒期不良反应的影响。方法:选择90例择期行腹腔镜胆囊切除术患者,随机均分为3组:地佐辛组(男16例,女14例)、芬太尼组(男15例,女15例)、曲马多组(男17例,女13例)。术毕关气腹前各组分别以地佐辛0.1mg/kg,芬太尼0.002mg/kg,曲马多2mg/kg静脉注射镇痛。3组病人均用咪达唑仑+异丙酚+舒芬太尼+顺式阿曲库铵静脉诱导后行气管插管,术中以吸入七氟醚和持续静注异丙酚麻醉。观察并记录各组24h内视觉模拟疼痛(VAS)评分、Ramsay镇静评分及不良反应发生例数。结果:地佐辛组和芬太尼组在0.5、1、4h观察时段VAS评分明显低于曲马多组,差异均有统计学意义(P<0.05),12、24h各观察时段3组VAS评分差异无统计学意义;地佐辛组在0.5、1h观察时段Ramsay镇静评分显著高于芬太尼组和曲马多组(P<0.05),3组病例4、12和24h各观察时段Ram-say镇静评分差异无统计学意义(P<0.05);地佐辛组无恶心、呕吐,芬太尼组恶心4例、呕吐0例,曲马多组恶心14例、呕吐7例。结论:地佐辛静脉注射对全麻苏醒期不良反应有良好的治疗效果,用于腹腔镜胆囊切除术病人安全有效。

lower than those of the tramadol group at 0.5, 1,4 h after operation, there was statistical signif- icance（P〈0.05）. The VAS scores at 12,24 h in three groups had no statistical significance. The Ramsay sedative scores of the dezocine group were much higher than those of the fentany group and the tramadol group at 0.5,1 h after operation （ P 〈 0.05 ）, The Ramsay sedative scores at 4,12,24 h in three groups had no sta- tistical significance （P 〈 0.05）. There were no nausea and vomiting in dezocine group, 4 nausea and 0 vomiting in fentany group, and 14 nausea and 7 vomiting in tramadol group. CONCLLI- SION. Injecting the dezocine 0.1 mg/kg in vein is effective and safe when using in laparoscopic cholecgstectomy.