等效剂量地佐辛或芬太尼在妇科腹腔镜手术全身麻醉苏醒期的影响比较

Comparative effect of equivalent doses of dezocine or fentanyl during recovery period of general anesthesia in patients undergoing gynecological laparoscopic surgery

目的探讨等效剂量地佐辛或芬太尼对妇科腹腔镜手术全身麻醉苏醒期的影响。方法拟行妇科腹腔镜手术的成年患者60例,随机分为地佐辛组(D组)和芬太尼组(F组)。两组患者均使用丙泊酚、维库溴胺、瑞芬太尼诱导并维持麻醉,并于手术结束前20 min,分别给予静脉注射地佐辛0.1 mg/kg或芬太尼2.0μg/kg。记录两组患者麻醉苏醒期的呼吸恢复时间、唤醒时间、拔管时间、定向力恢复时间、镇静评分、舒适度评分和不良反应发生率。结果两组患者呼吸恢复时间、唤醒时间、拔管时间、定向力恢复时间和舒适度评分比较差异无统计学意义(P>0.05);D组患者镇静评分、不良反应发生率低于F组,差异有统计学意义(P<0.05)。结论妇科腹腔镜手术结束前20 min静脉注射地佐辛0.1 mg/kg相比芬太尼2.0μg/kg更合适,地佐辛不仅清醒程度高,不良反应少,而且麻醉恢复和苏醒期舒适度与芬太尼相当。

Objective To explore the effect of equivalent doses of dezoeine or fentanyl during recovery period ot general anesthesia in patients undergoing gynecological laparoscopic surgery. Methods Sixty eases of patients undergoing laparoscopic surgery were randomly divided into two groups,dezocine group（group D） and fentanyl group（group F）.The two groups of patients were induced and maintained by propofol,vecuronium and remifentanil.Twenty minutes before the end of operation,two groups of patients were respectively given with intravenous injection of dezoeine 0.1 mg/kg or fentanyl 2.0 μg/kg.The breathing recovery time,wake-up time,extubation time,directed recovery time,sedation score, comfort score and incidence rate of adverse reaction were recorded.Results The breathing recovery time,wake-up time, extubation time,directed recovery time,comfort score of two groups were compared,with on statiscal difference （/9〉0.05）. Sedation score and incidence rate of adverse reaction in group D were lower than that in group F,with statiscal differ- ence（P〈0.05）.Condusion Compared with fentanyl 2.0 p,g/kg,intravenous injection of dezocine 0.1 mg/kg twenty min utes before the end of operation is more suitable for patients undergoing gynecological laparoscopie surgery.Dezoeine has higher level of consciousness awakening and fewer adverse reactions,and has similar recovery and comfort with fen- tanyl.