地佐辛在直肠癌根治术后全身麻醉恢复期间的安全性和有效性探讨

Evaluation of the safety and effectiveness of a postoperative intravenous injection of Dezocine on the recovery from emergency agitation in patients receiving radical resection of rectal carcinoma

目的探讨地佐辛在直肠癌根治术后全身麻醉恢复期间的安全性和有效性。方法66例受试者为2015年2月至2017年1月在我院接受七氟醚-芬太尼麻醉下直肠癌根治术的高龄患者，随机分为对照组和观察组，各33例。手术结束前15 min，观察组地佐辛0.1 mg/kg静脉注射，对照组注射相同剂量的生理盐水。记录两组患者苏醒期躁动（EA）、不良反应发生率及血流动力学指标。结果观察组患者给药后T1-T4时间点的平均动脉压和心率均小于对照组（tMAP＝3.228、3.603、5.431、5.568，tHR＝3.447、3.739、4.425、4.476，均P〈0.05）。观察组的EA发生率降至6.1%，小于对照组的24.2%（χ2＝4.242，P＝0.039）。观察组患者麻醉后监护室住院时间（54±11）min少于对照组（72±12）min（t＝9.317，P＝0.000）。此外，观察组患者在拔管期间各时间点的躁动评分和Ramsay镇静评分均低于对照组（t躁动＝2.862、3.348、3.411、3.159，tRamsay＝3.508、3.617、3.207、2.931，均P〈0.05）。结论在高龄患者直肠癌根治术后预注地佐辛可获得较好的镇痛效果，有效降低了EA的发生率，并保持血流动力学平稳。

ObjectiveTo investigate the safety and effectiveness of a postoperative intravenous injection of Dezocine on the recovery from emergency agitation after Sevoflurane-based anesthesia in patients receiving radical resection of rectal carcinoma.MethodsA total of 66 patients receiving Sevoflurane Fentanyl anesthesia during radical resection of rectal cancer in our hospital from February 2015 to January 2017 were enrolled.They were randomly divided into a control group （normal saline, n=33） and an observation group （Dezocine, n=33）. At 15 minutes before the end of operation, the control group received an intravenously administered normal saline, and the Dezocine group received 0.1 mg/kg dezocine in normal saline.The emergency agitation （EA）, incidence of adverse reactions, and hemodynamic indexes were collected in both groups.ResultsThe mean values of arterial blood pressure （MAP） and heart rate （HR） were significantly lower in the observation group than in control group at all four observation time points （tMAP=3.228, 3.603, 5.431, 5.568; tHR=3.447, 3.739, 4.425, 4.476; all P〈0.05）. The incidence of EA was significantly lower in the observation group （6.1%） than in the control group （24.2%） （χ2=4.242, P=0.039）. The stay time in post-anesthesia care unit （PACU） was significantly shorter in the observation group [（54±11） min] than in the control group [（72±12） min] （t=9.317, P=0.000）. In addition, the observation group had lower agitation scores and lower Ramsay sedation scores compared with the control group at all time points during extubation （tagitation=2.862, 3.348, 3.411, 3.159; tRamsay=3.508, 3.617, 3.207, 2.931; all P〈0.05）.ConclusionsThe use of Dezocine during anesthesia recovery period in patients undergoing radical resection of rectal cancer has an analgesic effect.It can effectively reduce the incidence of EA and maintain hemodynamic stability.