地佐辛对胆囊切除术内脏牵拉反应的观察

To observe the curative effect of dezocine on the visceral traction reaction in abdominal cholecystectomy under epidural anesthesia

观察地佐辛对硬膜外麻醉下经腹胆囊切除术内脏牵拉反应的疗效。方法：选择60例欲行经腹胆囊切除术的患者,ASAⅠ~Ⅱ级,拟施连续硬膜外麻醉,随机分为地佐辛组（D组）和芬太尼组（F组）,各30例。两组均在切皮前2min静脉分别给以地佐辛0.1mg/kg,芬太尼1~2ug/kg,常规检测,并对牵拉反应抑制效果进行评估,观察患者恶心、呕吐、疼痛等发生率。观察记录点分别为术前（T1）,切皮后5min（T2）,切皮后15min（T3）,牵拉胆囊时（T4）,胆囊切除后（T5）。结果：血流动力学比较,D组比F组在BP、HR更好地维持平稳,差异有统计学意义（P〈0.05）;胆囊牵拉反应,D组少于F组,差异有统计学意义（P〈0.05）。结论：地佐辛可以提供良好的镇痛效果,在内脏牵拉方面也有很大的优势,可以减少恶心呕吐的发生。

To observe the curative effect of dezocine on the visceral traction reaction in abdominal cholecystectomy under epidural anesthesia Methods： Select 60 patients ,ASA I - II grade, undergoing abdominal cholecystectomy in continuous epidural anesthesia. They were randomly divided into two groups, respectively named dezocine group （group D） and fentanyl group （group F）, 30 cases in each. The two groups were given 2 min intra- venously before skin incision respectively dezocine 0.1mg/kg and fentanyl 1-2ug/kg, and inhale oxygen by mask, monitored conventionally. The inhibition effect of the visceral traction reaction was evaluated, and observe the inci- dence of pain, nausea and vomiting. Time observation points were preoperative （T1）, 5min after skin incision （T2）, 15min after skin incision （T3）, pulling gallbladder （T4）, after cholecystectomy （T5）. Results： Compared with group F, BP and HR in group D remained more stable, with statistical significance （ P〈0.05 ）; In the aspect of gallbladder traction reaction, the incident in the group D was lower than that in the group F, and there was statistically significant （P〈0.05）. Conclusion.＂ Dezocine can provide a good analgesic effect ,also have a lot of advantages in the aspect of the visceral trac- tion, so it can reduce the incidence of nausea and vomiting. But the optimal dose and the optimal time tests are needed in the further studv to Drove the best effect.