地佐辛两种不同给药方式在瑞芬太尼复合麻醉术后苏醒期的效果

Effects of two different drug delivery ways of dezocine in the wakening period of remifentanil compound anesthesia

目的:研究地佐辛两种不同给药方式在瑞芬太尼复合麻醉术后苏醒期的效果。方法:收治的96例行腹腔镜胆囊切除术的患者为研究对象,根据地佐辛给药方式不同分为A组与B组,每组32例;使用芬太尼镇痛的32例患者设为对照组即C组。A组:手术结束前30 min肌注0.2 mg/kg地佐辛;B组:手术结束前30 min静脉注射0.2 mg/kg地佐辛;C组:手术结束前15 min静脉注射1μg/kg芬太尼。比较3组患者术后苏醒时间以及镇痛效果。结果:A组术后苏醒时间及拔管时间、苏醒后2 h视觉模拟评分法(visual analogue scale/Score,VAS)评分、苏醒后各时间段焦虑自评量表(self-rating anxiety scale,SAS)评分情况均优于B组与C组(P<0.05);A组不良反应发生情况优于B组与C组(P<0.01)。结论:手术结束前30 min肌注地佐辛在瑞芬太尼复合麻醉术后苏醒期的效果更佳,能有效减轻瑞芬太尼复合麻醉患者术后痛觉过敏反应,缩短苏醒时间以及拔管时间,不仅可以提高镇痛效果而且安全性高、不良反应少,值得在临床实践中推广。

Objective：To research the effects of two different drug delivery ways of dezocine in the wakening period of remifentanil compound anesthesia. Methods： 96 cases of patients who underwent laparoscopic cholecystectomy were divided into group A and B according to different drug delivery ways of dezocine, 32 cases in each group; 32 patients treated with fentanyl were in group C （control group）. 0.2 mg/kg dezocine was in- tramuscularly injected 30 minutes before the end of surgery in group A ; 0.2 mg/kg dizocine was intravenously injected 30 minutes before the end of surgery in group B and 1 ug/kg fentanyl was intravenously injected 15 minutes before the end of operation in group C. The postoperative resusci- tation time and analgesic effect were compared in the three groups. Results： The postoperative resuscitation and extubation time, VAS scores 2 hours after resuscitation and VAS scores at each time period after resuscitation in group A was better than those in group B and group C （ P 〈0.05 ）. Adverse reaction occurrence in group C was better than those in group A and group B （ P 〈0.01 ）. Conclusions： Intramuscular injec- tion of dezocine 30 minutes before the end of surgery in the wakening period of remifentanil compound anesthesia is more effective, and can effec- tively reduce postoperative pain allergic reaction, shorten the resuscitation time and extubation time. With high safety and less adverse reaction, it can also improve the analgesic effect and is worth popularizing in clinical practice.