地佐辛不同给药时间对七氟醚复合麻醉患者恢复期躁动的影响

Effect of different dazocine-taking times on emergence agitation after sevoflurane anesthesia

目的探讨地佐辛不同给药时间对七氟醚复合麻醉患者恢复期躁动的影响。方法择期行腹腔镜胆囊切除术的美国麻醉医师协会(ASA)分级Ⅰ~Ⅱ级患者90例,采用随机数字表法,将患者分为三组(n=30):A组麻醉前诱导时静脉注射地佐辛0.1 mg/kg,麻醉结束前静脉注射0.9%氯化钠溶液5 m L;B组麻醉诱导时静脉注射地佐辛0.05 mg/kg,麻醉结束前静脉注射地佐辛0.05 mg/kg;C组麻醉诱导及结束时静脉注射0.9%氯化钠溶液5 m L。观察T0(麻醉诱导前)、T1(气管插管时)、T2(手术开始后5 min)、T3(气管拔管时)及T4(手术结束后10 min)患者的平均动脉压(MAP)、心率(HR);记录术后t0(拔管时)、t1(拔管后15 min)、t2(拔管后30 mim)视觉模拟评分(VAS);Ricker镇静-躁动评分(SAS)及患者术后不良反应,记录拔管时间、麻醉后恢复室(PACU)停留时间。结果三组患者麻醉诱导前MAP、HR差异均无统计学意义(P>0.05)。C组在T3、T4时点MAP、HR均较A、B组明显升高,差异有统计学意义(P<0.05);B组在T3的MAP、HR较A组升高明显,差异均有统计学意义(P<0.05)。A、B组术后各时点VAS、SAS评分低于C组,A组t0及t1时VAS、SAS评分低于B组,差异均有统计学意义(P<0.05)。三组拔管时间,PACU停留时间及术后不良反应发生率比较差异均无统计学意义(P>0.05)。结论 0.1 mg/kg地佐辛诱导期给药用于七氟醚复合麻醉患者,可安全有效地降低术后烦躁发生率。

Objective To investigate the effect of dezocine with different taking times on emergence agitation after sevoflurane anesthesia. Methods Ninety patients American society of anesthesiologists（ASA）Ⅰ-Ⅱ undergoing laparoscopic cholecystectomy surgery under general anesthesia were randomly divided into three groups（n=30）. Dazocine was intravenously injected with 0.1 mg/kg on the anesthetization induction in group A;Dazocine was intravenously injected with0.05 mg/kg in the anesthetization induction and the same dosage before anesthesia ends in group B;0.9% sodium chloride solution was intravenously injected with 5 m L on the anesthetization induction and before the end of the anesthesia in group C. Mean arterial pressure（MAP） and heart rate（HR） were recorded at the following time points ： T0（before anesthesia）,T1（tracheaintubation）,T2（5 minutes in the operation）,T3（trachea extubation）,T4（10 minutes afteroperation）. Emergence agitation scores and Postoperative pain scores were assessed by visual analogue scale（VAS）and Ricker sedation-agitation scale（SAS）at T0 tracheal extubation,T1（15 min after extubation）,T2（30 min after extubation）,respectively. Extubation times,the duration times when the patient were in postanesthesia care unit（PACU） and the incidence of adverse effects were recorded. Results All the indexes before anesthesia had no significant difference among the three groups（P〉0.05）. MAP and HR in group C were obviously increased than those of group A and group B at T3 and T4（P〈0.05）. MAP and HR in group B were obviously increased than those of group A at T3（P〈0.05）. VAS and SAS of group A and group B were obviously higher than those of group C at all time point;VAS and SAS of group A were obviously higher than those of group B at T0,T1;There was no significant difference in the extubation time,length of stay in the PACU and adverse reaction between the three groups（P〈0.05）. Conclusion Dezocine 0.1 mg/kg was intravenously injected in the anesthetization induction can safely and effectively prevent EA after sevofluane anesthesia.