脑电双频指数监测下不同剂量地佐辛对全身麻醉苏醒期躁动程度的影响

Effects of different doses of dezocine on degree of emergence agitation under bispectral index monitoring

目的：分析脑电双频指数监测下不同剂量地佐辛对全身麻醉苏醒期躁动程度的影响。方法：选取2012年9月～2014年12年间在本院接受全身麻醉的患者196例作为研究对象，在麻醉诱导及麻醉拔管苏醒期间均持续进行脑电双频指数（BIS）监测，根据接受的地佐辛干预方法不同随机分为对照组、D1组、D2组、D3组各49例。对比各组患者的苏醒时间相关指标，给地佐辛前（T0）、拔管前吸痰时（T1）、拔管时（T2）、拔管后10min（T3）的BIS值、血流动力学指标、应激指标水平差异。结果：D2组患者的苏醒时间及拔管时间短于对照组、D1、D3组，拔管后躁动评分、VAS评分值低于对照组、D1，Ram—say镇静评分高于对照组及D1组患者（P〈0．05）；D2、D3组患者的T1、T2、T3时间点BIS值低于对照组、D1组，D2组的相同时间点BIS值高于D3组（P〈0．05）；D2、D3组的T1、T2、T3时收缩压、舒张压、心率低于对照组及D1组（P〈0．05），D2组的T1、T2、T3时收缩压、舒张压、心率与D3组相比差异无统计学意义（P〉0．05）；D2、D3组的T1、T2、T3时间点皮质醇及血糖水平低于其他两组（P〈0．05），D2组与D3组T1、T2、T3时间点皮质醇及血糖水平差异无统计学意义（P〉0．05）。结论：手术结束前给予0．1mg／kg地佐辛，可以减少麻醉苏醒期躁动，又不会导致镇静过度及拔管时间延长，在稳定患者拔管期血流动力学及应激水平均有积极意义。

Objective： To analyze the effects of different doses of dezoeine on degree of emergence agitation under bispectral index monitoring. Methods： A total of 196 patients who underwent general anesthesia in our hospital were selected as research subjects, hispectral index （BIS） monitoring was continuously eonducted during anesthesia induction and extubation anesthesia recovery, and according to different methods of dezocine intervention, these patients were randomly divided into con-trol group, D1 group, D2 group and D3 group, with 49 cases in each group. Differences in levels of recovery time related indexes, BIS values before dezocine administration （T0）, sputum suction before extubation （T1）, extubation time （T2） and 10 min after extubation （T3）, hemodynamic indexes and stress indexes of all groups were compared. Results： Recovery time and extubation time of D2 group were significant shorter than those of control group, D1 group and D3 group. Restlessness scale after extubation and VAS were lower than those of control group and D1 group, but Ramsay sedation scale was higher than that of control group and D1 group （P〈0.05）. BIS values at T1, T2 and T3 points in time of D2 and D3 group were lower than those of control group and D1 group. BIS values at T1, T2, and T3 of D 2 group and D3 group were significant lower than those of the control group, and among D1, D2 and D3 group, values at these time points were the lowest. Diastolic blood pres- sure and heart beat rate at T1, T2 and T3 points of D2 and D3 group were lower than those of control group and D1 group （P〈0.05）, and differences in systolic blood pressure, diastolic blood pressure and heart beat rate at T1, T2 and T3 points between D2 group and D3 group were not significant （P〉0.05）. Cortisol and blood glucose levels at time points of T1, T2 and T3 of D2 and D3 group were lower than those of other two groups （P〈0.05）, and differences in cortisol and blood glucose levels at T1, T2 and T3 between D2 group and D3 group were not significant （P〉0.05）. Conclusion： Administration of 0.1 mg/ kg dezocine before the end of operation can reduce emergence agitation without causing excessive sedation or prolonging extubation time, and are good for stabilizing patients＇hemodynamic and stress levels in extubation period.