地佐辛预防腹腔镜胆囊切除术患者全麻拔管期躁动的效果观察

The Effect of Dezocine on the Prevention of General Anesthesia Extubation Agitation of Laparoscopic Cholecystectomy

目的探讨地佐辛预防腹腔镜胆囊切除术患者全麻拔管期躁动的临床效果。方法选取湖北省宜都市某医院2012年8月-2014年8月收治的40例全麻腹腔镜胆囊切除术患者作为研究对象,随机分为A组(22例)与B组(18例)。2组患者的手术、麻醉形式相同,A组患者于手术结束前15min给予地佐辛静注,B组患者未给予特殊处理,比较2组患者诱导前(T0)、拔管时(T1)、拔管后10min(T2)时心率(HR)、平均动脉压(MAP)的变化情况以及麻醉后疼痛、镇静、躁动评分情况,并观察麻醉后2组患者的不良反应发生情况。结果2组患者麻醉后疼痛评分,组间比较差异无统计学意义;A组患者躁动评分为0.84±0.26,低于B组(1.27±0.52),组间比较差异有统计学意义(P<0.05);A组患者镇静得分为2.14±0.54,高于B组(0.74±0.21),组间比较差异有统计学意义(P<0.05)。2组患者T0时的HR及MAP比较,差异无统计学意义;A组患者T1,T2时的HR及MAP均低于B组,组间比较差异有统计学意义(P<0.05);A组患者出现恶心1例、呕吐1例,不良反应发生率为9.09%,B组患者出现恶心1例,便秘1例,不良反应发生率为11.11%,2组患者不良反应发生率比较,差异无统计学意义。结论地佐辛可缓解全麻腹腔镜胆囊切除术患者可缓解拔管期躁动,并有较好的镇静效果,具有较高的临床应用价值。

Objective To investigate the clinical effect of Dezocine on the prevention of general anesthesia extu- bation agitation of laparoscopic eholecystectomy. Methods 40 cases of patients received in a hospital of Yidu city from August 2012 to August 2014 who had laparoscopic cholecystectomy with general anesthesia were randomly divided into Group A （22 cases） and Group B （18 cases）. Patients in both groups had the same sur- gery and anesthesia, but patients of Group A were injected Dezocine intravenously 15 minutes before the end of their operation and patients of Group B were not. Two groups were compared changes of their heart rate （HR） and mean arterial pressure （MAP） before inducement （T0）, extubation （T1） and 10 minutes after extubation （T2） and the scores of pain, sedation and agitation after anesthesia, and patients in both groups were observed their adverse reactions after anesthesia. Results For pain scores after anesthesia, the difference between the two groups was not statistically significant; the agitation score of Group A was 0.84 ± 0.26, lower than Group B （1.27±0.52）, and there was statistically significant difference between the two groups （P〈0.05） the se dation score of Group A was 2.14 ± 0.54, higher than Group B （0.74 ± 0.21） and the difference was statistically significant （P〈0.05）. The differences between the two groups in MAP and HR of To were not statistically significant; MAP and HR of TI and T2 in Group A were lower than Group B and the differences were statisti- cally significant （P〈0.05） ; there was one case of nausea and one case of vomiting in Group A, and the inci- dence of adverse reactions was 9.09%, there was one case of nausea and one case of constipation in Group B, and the incidence of adverse reactions was 11.11 %, and the difference in the incidence of adverse reactions was not statistically significant. Conclusion Dezocine can relieve extubation agitation of laparoscopic cholecystecto- my with general anesthesia with a good sedative effect and it has high clinical value.