不同剂量的地佐辛对腹腔镜手术患者苏醒期躁动的影响

Effect of different dose of Dezocine acting on patients undergoing laparoscopic surgery during recovery period with agitation

目的 研究临床常用剂量的地佐辛对腹腔镜手术患者苏醒期躁动的影响.方法 选择ASA Ⅰ～Ⅱ级,年龄30 ～60岁,择期腹腔镜下子宫或附件切除术患者90例,随机分为地佐辛5mg组（D1组）、地佐辛10 mg组（D2组）和对照组（C组）,每组30例;手术结束前15分钟D1、D2组分别静注地佐辛5 mg和10 mg,C组静注等容量生理盐水.观察各组患者拔管后在手术间或PACU的RS躁动评分、VAS视觉模拟评分、Ramsay镇静评分（RSS）,苏醒时间和呼吸抑制、恶心呕吐的发生率.结果 D1、D2组RSS躁动评分和发生率明显小于C组（P＜0.05）,D2组又明显小于D1组（P＜0.05）;三组患者苏醒时间和药物不良反应差异无统计学意义.结论 手术结束前15 min静脉注射地佐辛10 mg可安全有效的预防全麻后患者躁动,减轻疼痛反应,且不良反应少.

Objective To investigate the effect of usual dose of Dezocine acting on patients undergoing laparoseopic surgery during recovery time with agitation. Methods 90 patients with ASAI-II, aged 30 - 60, undergoing electively laparoscopic hysterectomy or adnexectomy were involved and divided into 3 groups randomly： group Dezoeine 5mg（ group D1 ）, group Dezocine 10rag（ groupD2）, and control group（ group C）, each group of 30 patients. At 15 mins before operation ended, patients in group D1 and group D2 were intravenously given Dezocine 5mgs and Dezocine 10mgs separately, and patients in group C were given same volume NS I. V. Then observe patients＂ RS, VAS, RSS, recovery time, occurrence of respiratory depression, nausea and vomiting in each group after exudation while they were still in the operation room or PACU. Results RS and adverse reaction occurrence rate in group D1 and D2 were obviously lower than group C （ P 〈 0.05 ） and clearly, these in group D2 was lower than group D1 （P 〈 0. 05 ） ;there was no statistical difference of recovery time and medication adverse reaction in these three groups. Conclusions Safely and effectively, patients＂ agitation after general anesthesia can be prevented by giving Dezoeine 10mgs I.V. 15mins before operation ended, and this can also relief patients＇feeling of pain with less adverse reaction.