舒芬太尼和地佐辛用于三叉神经痛射频温控热凝术麻醉的对比观察

Comparison of sufentanil and dezocine anesthetic effects on trigeminal neuralgia undergoing radiofrequency thermocoagulation

目的：探讨舒芬太尼和地佐辛用于三叉神经痛射频温控热凝术麻醉的临床效果。方法：择期行射频温控热凝术ASAⅠ～Ⅱ级原发性三叉神经痛患者80例,随机分为2组：舒芬太尼＋丙泊酚（S组）和地佐辛＋丙泊酚（D组）。于麻醉诱导前（基础值）、穿刺时、加温和术毕时记录SBP,DBP,HR,RR,SpO2;记录丙泊酚用量及术后清醒时间;术中麻醉镇痛效果观察;记录手术过程中不良反应发生率。结果：基础值比较差异无统计学意义（P〉0.05）;与基础值比较,两组在穿刺时RR,SpO2均降低,且两组加温时SBP,DBP,HR,RR,SpO2均降低,差异有统计学意义（P〈0.05）;S组穿刺及加温时RR,SpO2均低于D组,差异有统计学意义（P〈0.05）;两组术后清醒时间和丙泊酚用量差异无统计学意义（P〉0.05）,与S组比较D组不良反应中呼吸抑制发生率降低（P〈0.05）;S组麻醉镇痛总有效率为97.5%,D组麻醉镇痛总有效率为95%,两组比较差异无统计学意义P〉0.05）。结论：本研究结果表明地佐辛用于三叉神经痛射频消融手术的麻醉,不会影响患者在术中的配合,可以有效的起到镇痛效果,减少心率及血压的变化,术后患者可以快速清醒。但在与丙泊酚并用时仍应注意呼吸抑制的发生。

Objective： To compare the anesthetic effects of sufentanil and dezocine on trigeminal neuralgia undergoing radiofrequency thermocoagulation. Methods： Eighty ASA I ～ II patients with trigeminal neuralgia undergoing radiofrequency thermocoagulation were randomized into two groups,and treated with either sufentanil ＋ propofol or dezocine ＋ propofol. Systolic blood pressure（ SBP）,diastolic blood pressure（ DBP）,heart rate（HR）,respiratory rate（RR） and pulse oxygen saturation（SpO2） were recorded before anesthesia induction,during puncture and warming and after operation. The amount of propofol used and the time of anesthesia recovery were recorded. The analgesic effects during anesthesia were observed,and the adverse reactions were recorded in the operation. Results： The baseline variables were not significantly different（ P〉0. 05）. RR and SpO2during puncture were lower than baseline values. HR,DBP,SDP,RR and SpO2declined during warming in two groups. RR and SpO2was lower in sufentanil group than in dezocine group（P〈0. 05）. The amounts of propofol used and the time of anesthesia recovery in two groups were not statistically significant（P〉0. 05）. The incidence of respiratory depression was less in sufentanil group than in dezocine group（P〈0. 05）. The percentages of analgesic effect was 97. 5% in dezocine group and 95% in sufentanil group,and the difference in two groups was not statisticallysignificant（P〈0. 05）. Conclusion： The use of dezocine in trigeminal neuralgia patients undergoing radiofrequency thermocoagulation not only has analgesic effect,but also protects HR,DBP,SDP,RR and SpO2from fluctuating obviously. After the operation,patients＇ recovery time is shorter. However,we should pay attention to the incidence of respiratory depression when combined with concurrent use of propofol.