地佐辛复合七氟醚在膀胱黏膜白斑电切术中的应用

Application of dezocine combined with sevoflurane in treatment of patients with leukoplakia transurethral bladder electrocision

目的观察地佐辛复合七氟醚吸入行膀胱黏膜白斑电切术的麻醉效果。方法择期行膀胱黏膜白斑电切术患者90例随机分成地佐辛复合七氟醚组(D组),芬太尼复合七氟醚组(F组)和单纯七氟醚组(Q组),每组30例。记录麻醉开始前(T0)、手术开始前(T1)、电切开始后(T2)、手术结束时(T3)和患者清醒后5 min(T4)各时点的平均动脉压(MAP)、心率(HR)、脉搏氧饱和度(Sp O2)和呼吸频率(RR);记录麻醉起效时间、意识恢复时间、术中体动和呼吸抑制情况及术后下腹部胀痛不适情况。结果 D组和F组各时点MAP、HR、RR和Sp O2无显著差异(P>0.05);在T2和T3时点,Q组的MAP、HR和RR与D组和F组比较差异有统计学意义(P<0.0 5);在T4时点,Q组的MAP、HR与D组和F组比较差异有统计学意义(P<0.05);Q组麻醉起效时间较D组和F组长(P<0.05);Q组术中体动及术后尿胀不适患者明显较D组和F组多(P<0.05)。结论地佐辛和芬太尼复合七氟醚吸入均可以用于膀胱黏膜白斑电切术,但地佐辛复合七氟醚吸入用于膀胱黏膜白斑电切术的麻醉效果更佳。

Objective To observe the anesthesia effect of dezocine combined with sevoflurane inhalation in treatment of patients with leukoplakia transurethral bladder electrocision. Methods Ninety patients underwent leukoplakia transurethral bladder electrocision were randomly divided into dezocine combined with sevoflurane group （group D）, fentanyl combined with sevoflurane group （group F） and sevoflurane group （group Q）, 30 cases in each group. MAP, HR, SpO2 and RR at the time points of the start of anesthesia （T0）, before surgery （T1）, electrocision after the start （T2）, the end of surgery （T3） and 5 minutes after awaking （T4） were recorded. The onset time of anesthesia, consciousness recovery time, body movement and respiratory inhibition in operation, lower abdominal pain and discomfort after surgery were recorded as well. Results There were no significant differences of MAJ？, HR and SpOe between group D and group F at each time point （P 〉0.05）. The MAP, HR and RR in group Q were significantly higher than those in group D and group F at T2 and T3 （P 〈 0.05）. The MAP and HR in group Q were significantly higher than those in group D and group F at： T4 （P 〈 0.05）. The onset time of anesthesia in group Q was significantly longer than that in group D and group F （P 〈 0.05）. The number of the pa tients had intraoperative body movement or urinary distention after surgery was more than that in group D and group F （P 〈 0.05）. No patients suffered postoperative urinary distention in Group D. Conclusion Dezocine and fentanyl combined with sevoflurane respectively can be used in treatment of patients with leukoplakia transurethral bladder electrocision, but the anesthesia effect of dezocine combined with sevoflurane is better.