地佐辛预防腹腔镜胆囊切除术患者全麻苏醒期躁动临床疗效观察

Preventive effect of dezocine sodium on emergence agitation after laparoscopic cholecystectomy

目的评价地佐辛对腹腔镜胆囊切除术(LC)患者全麻苏醒期躁动的影响。方法选择全身麻醉下行LC术患者60例(ASAⅠ～Ⅱ级),并随机分为3组。观察组:关腹前30 min分别肌肉注射地佐辛0.1 mg/kg(A组,n=20)、0.2 mg/kg(B组,n=20)对照组:给予5 ml 0.9%氯化钠溶液静注(C组,n=20)。比较3组患者全麻清醒时间、拔管时间、拔管时患者的血流动力学指标、拔管后的视觉模拟评分法(VAS)、苏醒期躁动发生率及拔管后苏醒室内患者恶心呕吐和呼吸抑制等不良反应情况。结果 3组患者的全麻清醒时间、拔管时间差异无显著性;但拔管时的心率(HR)、平均动脉压(MAP)和全麻苏醒期躁动发生率A组和B组明显低于C组(P<0.05),且无呼吸抑制;苏醒后VAS评分C组最高,A组和B组次之(P<0.05)。拔管后苏醒室内恶心呕吐的发生率C组明显高于A组和B组(P<0.01)。结论0.2 mg/kg地佐辛于手术结束前30 min肌肉注射可以明显降低LC患者全麻苏醒期躁动的发生率。

Objective To evaluate the preventive effect of dezocine sodium on emergence agitation after laparoscopic cholecystectomy （LC）. Methods Sixty patients （ ASA I - II ） undergoing general anesthesia for LC were randomly assigned to three groups. Patients in observation group were given intramuscular 0.1 mg/kg （ group A, n = 20） or 0.2 mg/kg （ group B, n =20） of dezocine 30 minutes before abdominal closure. Subjects in control group （ group C, n = 20 ） were given intravenously 5 ml of normal saline solution. Recovery and extubation time, hemodynamic parametem during extubation, the VAS pain score after extubation, incidence of emergence agitation, and adverse reactions including nause- a, vomiting and respiratory depression after extubation were recorded. Results There were no significant differences between three groups in awake time and extubation time during emergence from general anesthesia. However, HR, MAP and incidence of agitation in group A and B were significantly lower than in group C （ P 〈 0.05 ）, and no respiratory depression was found in the observation group. The VAS score of group C was significantly higher than that in group A and B after recovery （ P 〈 0. 05 ）. The incidence of nausea and vomiting was remarkably higher in Group C than that in groups A and B （ P 〈 0. 01 ） after extubation. Conclusion The study demonstrated that 0.2mg/kg of dezocine intramuscular injection 30 minutes before the end of surgery can significantly reduce the incidence of agitation during emergence from general anesthesia in patients after LC.