不同剂量地佐辛预先给药对全麻肛周手术病人镇痛效果观察

Analgesia effect of crissum patients with general anesthesia by intravenous dezocine pretreatment

目的探讨不同剂量地佐辛预先给药对肛周病人镇痛效果。方法 80例病人随机分为两组,每组40例,D1组为地佐辛0.1 mg/kg;D2组为地佐辛0.2 mg/kg;入室后,建立静脉通路,监测生命体征,采用预先给药15 min后,用2 mg/kg丙泊酚麻醉诱导,诱导后行局部浸润麻醉。麻醉维持丙泊酚2 mg/(kg·h)。记录两组患者麻醉前(T_1),手术开始5 min时(T_2),15 min时(T_3)HR,MAP,SPO_2及呼吸抑制时间,手术时间,苏醒时间、丙泊酚用量、术区疼痛程度。结果 HR,MAP,SPO_2:D1组与D2组,与T1时间点相比,两组T2时间点均有差异。SPO2在T2时间点,D1组与D2组比较差异有统计学意义(P<0.05)。丙泊酚追加量变化,与D1组比较,D2组丙泊酚追加量少,差异有统计学意义(P<0.05);D2组,中,重度呼吸抑制病人增多。结论无痛肛周手术麻醉中,不同剂量地佐辛预先给药可达到满意镇痛效果,0.1 mg/kg地佐辛呼吸抑制轻微。

Objective To discuss the analgesia effects of crissum patients by intravenous different dose of dezocine pretreatment. Methods Divided 80 cases of ASA Ⅰ-Ⅱ anorectal patients randomly into two groups,D1 group,40 cases,dezocine 0. 1 mg/kg 5 ml; D2 group,40 cases,dezocine 0. 2 mg/kg,5 ml. In the operating room,oxygen 2 L/min by mask. pretreatment dezocine randomly after establishing venous pathway and monitoring physical signs. 2 mg/kg propofol anesthesia induction after 15 min. Prepare long-narcotic mixing drug. Monitoring the heart rate（ HR）,mean arterial blood pressure（ MAP）,respiratory rate（ RR）,and blood oxygen saturation（ SPO_2）. Maintain propofol 2 mg/kg/h in anesthesia. Record HR,MAP,SPO_2 before anesthesia（ T_1）,5 min after the operation（ T_2）,15 min（ T_3）,and respiratory depression,operation time,recovery time,the dosage of propofol and record 24 h postoperative pain score.Results In D1 and D2 group,compared with T_1,there was statistical significance with HR,MAP and SPO_2 in T_2;Compared with T_2 in D1 group and D2 group,there was statistical significance difference with SPO_2. Two groups have no statistical significance of operation time. Compared with D1 group,additional quantity of propofol in D2 group was less.There was no statistical significance about the awaking hours in two groups. Compared with D1 group,the difference of pain score was statistically significant after 24 h by Verbal rating scale in D2 group. Conclusion In the crissum surgery,0. 1 mg/kg dezocine pretreatment can achieve satisfactory analgesia effect.