地佐辛在急诊饱胃患者全麻诱导中的应用效果观察

Observation of the effect of dezocine in induction of general anesthesia in patients with emergency full stomach

目的观察地佐辛在急诊饱胃患者全麻诱导中的应用效果。方法选择2017年1月-2018年12月南昌大学第四附属医院普外科饱胃患者需急诊行剖腹探查术患者60例,按照随机数字表法分为地佐辛组和生理盐水组各30例。2组均采用全麻气管插管,快速诱导:地佐辛组予咪达唑仑0.1 mg/kg、地佐辛0.1 mg/kg(2 ml)、芬太尼2μg/kg、注射用苯磺顺阿曲库铵0.1 mg/kg、丙泊酚2 mg/kg;生理盐水组予咪达唑仑0.1 mg/kg、生理盐水2 ml、芬太尼2μg/kg、注射用苯磺顺阿曲库铵0.1 mg/kg、丙泊酚2 mg/kg。比较2组患者麻醉诱导前(T0)、注药后1 min(T1)、2 min(T2)、5 min(T3)平均动脉压(MAP)、心率(HR)、血氧饱和度(Sp O2)及呛咳发生情况。结果2组患者T0、T1、T2、T3时点MAP、HR和Sp O2比较差异均无统计学意义(P>0.05);地佐辛组患者呛咳发生率低于生理盐水组(P<0.05),呛咳控制良好率高于生理盐水组(P<0.05)。结论地佐辛可显著减少饱胃患者麻醉诱导时呛咳反射,减少呕吐反流误吸的风险,保证麻醉诱导平稳。

Objective To observe the effect of dezocine in induction of general anesthesia in patients with emergency full stomach.Methods 60 cases of patients with emergency full stomach in department of anesthesiology,the Fourth Affiliated Hospital of Nanchang University from January 2017 to December 2018 were selected,and they were divided into the dezocine group(30 cases)and the normal saline group(30 cases)according to the random number table method.Both groups were intubated with general anesthesia.Rapid induction:The dizocine group was given midazolam 0.1 mg/kg,dizocine0.1 mg/kg(2 ml),fentanyl 2μg/kg,cisatracurium besilate for injection 0.1 mg/kg,propofol 2 mg/kg;The normal saline group was given 0.1 mg/kg midazolam,2 ml normal saline,2μg/kg fentanyl,0.1 mg/kg cisatracurium besilate for injection,and 2 mg/kg propofol.The mean arterial pressure(MAP),heart rate(HR),and Sp O2 of the two groups were compared before induction of anesthesia(T0),1 min(T1),2 min(T2),5 min(T3)after injection.Results There were no significant differences in MAP,HR,and Sp O2 at T0,T1,T2,and T3 between the two groups(P>0.05);The incidence of scabies in the dizocine group was lower than that in the saline group(P<0.05),and the rate of good cough control was higher than that in the saline group(P<0.05).Conclusion Dizocine can significantly reduce gag reflex during anesthesia induction in patients with full stomachs,reduce the risk of vomiting regurgitation and aspiration,and ensure the stability during anesthesia induction.