摘要
目的 观察地佐辛抑制雷米芬太尼和丙泊酚静脉复合麻醉下中、老年患者腹腔镜胆囊切除术(LC)后苏醒期疼痛的半数有效量(ED50)。方法 选择拟行LC的中年(中年组,45-54岁)和老年(老年组,65-74岁)患者各32例,两组麻醉诱导和维持用药方法一致,术中除雷米芬太尼外,不再追加任何镇痛药物。手术结束前10min采用改良序贯法静脉注射地佐辛。术毕停用丙泊酚和雷米芬太尼。拔管后30min测定患者VAS疼痛评分,VAS疼痛评分≥4分为术后急性疼痛。采用Probit回归方法分析地佐辛ED50并计算其95%可信区间(CI)。记录手术时间、拔管时间及术后不良反应情况。结果中年组使用地佐辛的剂量高于老年组[(0.147±0.015)mg/kg vs.(0.116±0.011)mg/kg](P〈0.05),地佐辛抑制两组患者苏醒期疼痛的ED50及95%CI分别为0.145(0.139-0.171)mg/kg和0.117(0.112-0.141)mg/kg。两组手术时间、拔管时间及术后不良反应发生率差异无统计学意义(P〉0.05)。结论 地佐辛抑制雷米芬太尼和丙泊酚静脉复合麻醉下中年患者LC后苏醒期疼痛的ED50值明显高于老年患者。
Objective To observe the median effective dose(ED20 ) of dezocine on acute pain after general intravenous anesthesia with remifentanil and propofol in middle-aged and elderly patients undergoing laparoscopic cholecystectomy(LC). Methods Thirty-two middle-aged patients(group A, 45-54 years old) and 32 elderly patients(group B, 65-74 years old) undergoing LC under general anesthesia were received same anesthesia induction and maintenance. No other analgesic drugs were added besides remifentanil. Dezocine was injected at 10 minutes before the end of surgery using modified Dixon's up-and-down method. Propofol and remifentanil were discontinued at the end of surgery. Postoperative pain was evaluated by VAS pain score at 30 minutes after extubation, and VAS pain score-4 points was defined as postoperative acute pain. ED50 and 95% confidence interval(CI)of dezocineon on postoperative acute pain were calculated by Probit method. The total operation time, extubation time and postoperative adverse effects were recorded. Results The consumption dose of dezocine in group A was higher than that in group B[(0. 147±0. 015)mg/kg vs. (0. 116±0. 011)mg/kg] (P〈0. 05). ED50 and 95%CI of dezocine on acute pain in groups of A and B were 0. 145(0. 139±0. 171) mg/kg and 0. 117(0. 112±0. 141)mg/kg, respectively. There were no significant differences in total operation time, extubation time and incidence of postoperative adverse effects between two groups (P〉0. 05). Conclusion The ED50 value of dezocine on acute pain after general intravenous anesthesia with remifentanil and propofol in middle-aged patients undergoing LC is significantly higher than that of elderly patients.
出处
《江苏医药》
CAS
2016年第22期2451-2453,2457,共4页
Jiangsu Medical Journal
关键词
地佐辛
全身麻醉
腹腔镜胆囊切除术
疼痛
半数有效量
Dezocine
General anesthesia
Laparoscopic cholecystectomy
Pain
Medianeffective dose