腹腔镜子宫切除手术麻醉诱导中应用地佐辛对循环和应激反应的影响

Effect of dezocine on circulation and stress response in laparoscopic hysterectomy induction of anesthesia

目的 探讨在腹腔镜子宫切除手术麻醉诱导中应用不同剂量地佐辛对应激反应和循环的影响.方法 随机选取2013年7月至2015年6月行腹腔镜子宫全切除术的患者120例,按照麻醉诱导方式的不同将其分为A、B、C、D四组,其中A组患者采用舒芬太尼0.5 μg/kg进行麻醉诱导,B、C、D组患者分别采用地佐辛0.1、0.2、0.3 mg/kg进行麻醉诱导,对患者不同时间点心率、平均动脉压进行观察记录,并对其皮质醇、肾上腺素、去甲肾上腺素浓度进行测定评估.结果 插管即刻及插管后2 min A、B、C三组患者的平均动脉压、心率均明显高于D组,差异有统计学意义（P〈0.05）;在不同时刻,D组患者去甲肾上腺素、肾上腺素水平均明显低于A、B、C三组,差异有统计学意义（P〈0.05）.结论 在腹腔镜子宫切除手术麻醉诱导中应用地佐辛有利于维持机体生命体征的平稳,其中地佐辛0.3 mg/kg效果最佳,有助于保证手术的顺利、安全进行.

Objective To investigate the effect of different doses dezocine on stress response and circulation in laparoscopic hysterectomy induction of anesthesia.Methods Randomly selected 120 patients with laparoscopic hysterectomy from July 2013 to June 2015,according to the induction of anesthesia in different ways,all the patients were divided into group A,group B,group C,group D,group A was treated with sufentanil 0.5 μg/kg induction of anesthesia,group B,group C,group D were respectively treated with dezocine 0.1,0.2,0.3 mg/kg induction of anesthesia,the patients＇ heart rates were observed and the mean arterial pressures of the patients at different points were recorded,and their cortisol,epinephrine,norepinephrine concentration were measured and assessed.Results The MAP,HR values at intubation and two min after intubation in group A,B and C were significantly higher than those in group D,the differences were significant （P 〈 0.05）;at different times,NE,E values of group D were significantly lower than those of the group A,B and C,the differences were significant （P 〈 0.05）.Conclusions In laparoscopic uterine surgery anesthesia induction using dezocine is conducive to the maintenance of the body＇s vital signs stable,and 0.3 mg/kg dezocine is the best,which can help to ensure the operation safely and smoothly.