摘要
目的比较地佐辛和芬太尼对老年患者神经外科术后镇痛效果及认知功能的影响。方法将拟行颅脑肿瘤切除术、美国麻醉师协会（ASA）评分Ⅱ～Ⅲ级老年患者42例，采用随机数字表法分为地佐辛组21例和芬太尼组21例。记录患者术毕停药至呼之睁眼和拔除气管导管时间，术前（T0）和拔管后1h（T1）、2h（T2）和3h（T3）镇痛（PIDS）、镇静（Ramsay）评分及认知功能简易精神量表评分（MMsE）。结果地佐辛组和芬太尼组比较，患者术毕呼之睁眼时间分别为（15．9±2．8）min比（16．2±4．3）min，拔除气管导管时间分别为（22．4±5．1）min比（23．8±3．7）min，差异无统计学意义（均P〉o．05）。镇静评分和MMSE评分，T1-T2期地佐辛组与芬太尼组间比较差异无统计学意义（P〉O．05）；地佐辛组与芬太尼组镇痛评分比较，T2期分别为（2．01±0．79）分比（2．55±0．51）分（t=-2．24，P=0．04），T3期为（2．30±0．66）分比（2．75±0．64）分（t=-2．44，P=0．03），地佐辛组均低于芬太尼组。结论对于老年神经外科患者，术毕前静脉应用地佐辛和芬太尼可取得良好的术后镇静镇痛作用，且不影响麻醉复苏和拔除气管导管时间；与芬太尼比较，地佐辛可维持更长的术后镇痛时间。
Objective To compare the effects of dezocine and fentanyl on analgesia and cognitive state for elderly patients after neurosurgery. Methods A total of 42 elderly patients with brain tumors and American Society of Anesthesiologists （ASA） Ⅱ-Ⅲ were randomly divided into two groups.. Dezocine group and fentanyl group （n= 21, each）. The time of recovery and extubation, pain intensity descriptive scale （PIDS）, Ramsay score and mini-mental state examination （MMSE） before operation, and 1 h, 2 h and 3 h after extubation were recorded. Results The time of recovery 〈（15.9±2.8） rain vs. （16.24±4.3）] min and extubation [（22.4±5.1） rain vs. （23.8± 3.7） mini between the two groups had no differences （ both P〉0. 05）. And there were no statistical differences between the two groups in Ramsay and MMSE score at 1 h, 2 h, 3 h after extubationand on PIDS at 1 h after extubation （ all P〉0. 05）. The PIDS were lower in Dezocine group than in fentanyl group at 2 h〈（2.01±0.79）scores vs. （2.55-1-0.51）scores, （t=-2.24, P=0.04）] and 3 h after extubation （2.30±0.66）scores vs. （2.75±0.64）scores, （t=-2.44, P= 0.03）]. Conclusions The using of dezocine and fentanyl before the end of operation could have a good sedative and analgesia effect on neurosurgery without influence on the duration of recovery and extubation, and dezocine may maintain a longer time of analgesia than fentanyl in elderly patients.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2012年第10期860-862,共3页
Chinese Journal of Geriatrics
