地佐辛对老年患者全麻苏醒质量的影响

Effects of Dezocine on Quality of Emergence from General Anesthesia in the Elderly Patients

目的:评价地佐辛对老年患者全身麻醉苏醒质量的影响。方法:老年腹部手术患者60例,ASA分级Ⅰ～Ⅲ级,随机分为三组:D组、F组、C组,每组20例,所有患者持续静脉输注瑞芬太尼-丙泊酚和顺苯磺酸阿曲库铵维持麻醉。手术结束前30min分别静脉注射地佐辛0.1mg/kg(D组)、芬太尼1μg/kg(F组)、生理盐水5ml(C组)。记录患者自主呼吸恢复时间(M1)、苏醒(OAA/S评分3～4分)时间(M2)、拔除气管导管时间(M3);拔除气管导管前后患者收缩压(SBP)、舒张压(DBP)、心率(HR)和患者拔管前后的RikerSAS评分(镇静躁动评分);拔管后30min、1h、2h、4h和6h的患者VRS痛觉评分。结果:M1、M2、M3值:D组明显短于F组(P<0.05),与C组则相近(P>0.05);SBP、DBP、HR值:D组在拔管前后各时点值明显低于C组和F组(P<0.05),F组在拔管前1min及拔管后1min、5min比C组低(P<0.05)。RikerSAS评分:D组拔管前后各时间点RikerSAS评分明显低于C组和F组(P<0.05),F组拔管前1min、拔管后1min、拔管后5min的RikerSAS评分低于C组(P<0.05)。VRS评分:D组各时间点VRS评分均低于C组和F组(P<0.05),F组拔管后30min、1h和2h的VRS评分比C组低(P<0.05)。结论:地佐辛0.1mg/kg静脉注射用于老年患者全身麻醉苏醒迅速,血流动力学稳定,RSS镇静满意,VAS镇痛良好,不良反应少,提高患者苏醒质量。

Objective： To evaluate the effects of dezocine on recovery quality for elderly patients undergoing general ： 60 cases of elderly patients undergoing abdominal operation, ASA grade I -]]I, were randomly divided into 3 groups （n=20）： group D, group F, and group C.All patients received general anesthesia with continuous infusion of remifentanil, propofol and eisatracurium besylate.At 30 minutes before the end of surgery, patients in D, F and C groups were intravenously injected with 0.1 mg/kg dezocine, and 1 tx g/kg fentany and 5 ml saline respectively.Spontaneous breathing recovery time （M1）, awakening （OAA/S score is 3-4） time （M2） and extubation time （M3） of all patients were recorded.Before and after extubation, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate （HR） and riker SAS score of all patients were monitored.At 30 min, 1 h, 2 h, 4 h, and 6 h after extubation, VRS pain score of all patients was observed.Results： M 1, M2 and M3 in group D were significantly shorter than that in group F（P〈0.05）, and were similar with that in group C（P〉0.O5）.At each time point of before and after extubation, SBP, DBP and HR in group D were obviously lower than that in group C, and group F（P〈O.O5）.At the time point of 1 min before and 1 min, 5 min after extubation, SBP, DBP and HR in group F was obviously lower than that in group C（P〈0.O5）.At each time point of before and after extubation, riker SAS score in group D were significantly lower than that in group C（P〈0.O5）.At each time point, the score of VRS in group D was significantly lower than that in group C and group F（P〈O.O5）.At the time point of 30 min, 1 h and 2 h after extubation, the score of VRS in group F was obviously lower than that in group C（P〈O.O5）.Conclusion： 0.1 mg/kg dezoeine intravenous injection for elderly patients undergoing general anesthesia can effectively improve the quality of emergence which makes awakening rapid, hemodynamic stable, RSS sedation ~atisth,＇lory, VAS anelgesia good, side effect decreasing.