丙泊酚注射液与地佐辛注射液对全麻下手术患者术后苏醒期躁动及术后镇痛的影响

Effects of propofol injection and digoxin injection on postoperative recovery period agitation and postoperative pain in patients undergoing general anesthesia

目的观察丙泊酚与地佐辛对全麻下手术患者术后苏醒期躁动及术后疼痛的效果。方法将52例全麻下手术的患者随机分为对照组及试验组,各26例。手术结束前15 min,对照组给予地佐辛0.15 mg·kg^(-1)+芬太尼0.6μg·kg^(-1),静脉注射;试验组给予地佐辛0.15 mg·kg^(-1)+丙泊酚2.0 mg·kg^(-1),静脉注射。比较2组患者术后睁眼时间、拔管时间、拔管时的平均动脉压、心率、镇静、疼痛评分及安全性。结果手术后,对照组和试验组患者睁眼时间分别为(13.28±0.63)和(9.21±0.37)min,对照组和试验组拔管时间分别为(17.23±1.14)和(13.74±1.02)min,对照组和试验组平均动脉压分别为(97.64±9.34)和(90.13±7.32)mm Hg,对照组和试验组心率分别为(86.34±5.27)和(78.46±6.47)time·min^(-1),差异均有统计学意义(均P<0.05)。对照组和试验组镇静和躁动评分分别为(5.03±0.45)和(3.49±0.17)分;视觉模拟评分(VAS)分别为(4.23±0.24)和(2.11±0.16)分,差异均有统计学意义(均P<0.05)。对照组药物不良反应有头晕、恶心呕吐,药物不良反应发生率为11.54%(3/26例);试验组药物不良反应有恶心、呕吐、低血压,药物不良反应发生率为7.69%(2/26例),差异无统计学意义(P>0.05)。结论与芬太尼复合地佐辛比较,丙泊酚联合地佐辛能够明显减轻全麻下神经外科手术患者术后苏醒期躁动及疼痛程度,稳定拔管时平均动脉压、心率,并且不延长苏醒及拔管时间,安全性较高。

Objective To evaluate the effect of propofol combined with dezocine on postoperative recovery period agitation and postoperative pain in patients with operation under general anesthesia. Methods A total of 52 patients with operation under general anesthesia were randomly divided into control group and treatment group,26 cases in each group. At15 min before the end of operation,control group was given dezocine0. 15 mg·kg^-1＋ fentanyl 0. 6 μg·kg^-1intravenous injection. Treatment group was treated with dezocine 0. 15 mg · kg^-1＋ propofol 2. 0mg·kg^-1,intravenous injection. Postoperative eye opening time,extubation time,extubation of mean arterial pressure（ MAP）,heart rate（ HR）,sedation,pain score and safety were compared between the two groups. Results After surgery,eye opening times in control group andtreatment group were（ 13. 28 ± 0. 63）,（ 9. 21 ± 0. 37） min. Extubation times in control group and treatment group were（ 17. 23 ± 1. 14）,（ 13. 74 ± 1. 02） min. The MAP in control group and treatment group were（ 97. 64 ± 9. 34）,（ 90. 13 ± 7. 32） mm Hg. The HR in control group and treatment group were（ 86. 34 ± 5. 27）,（ 78. 46 ± 6. 47）time·min^-1,with significant difference（ all P〈0. 05）. The sedation-agitation scales（ SAS） in control group and treatment group were 5. 03 ± 0. 45,3. 49 ± 0. 17. The visual analogue scales（ VAS） in control group and treatment group were 4. 23 ± 0. 24,2. 11 ± 0. 16,with significant difference（ all P〈0. 05）. In control group,adverse drug reactions were dizziness,nausea and vomiting,the incidence of adverse drug reactions was 11. 54%（ 3/26 cases）.The adverse drug reactions in treatment group were nausea,vomiting,hypotension and adverse drug reactions was7. 69%（ 2/26 cases）,with no significant difference（ P〉0. 05）. Conclusion Compared with fentanyl and dezocine,the propofol and dezocine can significantly reduce the degree of postoperative recovery period agitation and pain after operation in patients with operation under general anesthesia,stable extubation MAP and HR,and do not prolong the time of awakening and extubation,and the safety was high.