地佐辛联合罗哌卡因超前镇痛对乳腺癌改良根治术患者麻醉效果及术后躁动的影响

Effects of Preemptive Analgesia of Dezocine Combined with Ropivacaine on Postoperative Agitation in Patients Undergoing Radical Mastectomy

目的:探讨地佐辛联合罗哌卡因超前镇痛对乳腺癌改良根治术患者麻醉效果及术后躁动的影响。方法:将76例择期行乳腺癌改良根治术的患者随机均分为两组,每组38例。观察组在静吸全麻基础上联合罗哌卡因神经阻滞,并在麻醉诱导前静脉注射地佐辛0.1 mg/kg;对照组仅行静吸全麻联合罗哌卡因阻滞麻醉。比较两组患者麻醉后生命体征、镇静效果、术后疼痛程度、术后躁动及不良反应发生情况。结果:拔管后两组心率(HR)、收缩压(SBP)及舒张压(DBP)先升高后降低,且观察组各时间点HR、SBP及DBP均低于对照组,有统计学差异(P<0.05);呼吸频率(RR)无明显差异(P>0.05)。两组术后视觉模拟法(VAS)评分逐渐降低,组内各时间点有统计学差异(P<0.05),且相同时间点观察组VAS评分高于对照组,有统计学差异(P<0.05)。观察组Ramsay镇静评分高于对照组,躁动发生率及严重程度低于对照组,有统计学差异(P<0.05)。两组麻醉苏醒后不良反应发生情况无统计学差异(P>0.05)。结论:地佐辛联合罗哌卡因超前镇痛可有效提升乳腺癌改良根治术患者的镇痛效果,降低麻醉苏醒期间躁动发生率及严重程度,并维持血流动力学稳定,有利于患者术后康复。

Objective:To study the effects of preemptive analgesia of dezocine combined with ropivacaine on anesthetic effects and postoperative agitation in patients undergoing radical mastectomy.Methods:76 cases of patients undergoing radical mastectomy were randomly divided into two groups,with 38 cases in each group.Observation group was given ropivacaine nerve block on the basis of inhalation anesthesia and an additional intravenous injection of 0.1 mg/kg dezocine before anesthesia induction.Control group was only given inhalation anesthesia and ropivacaine block anesthesia.The vital signs,sedative effects,postoperative pain degree,postoperative agitation and occurrence of adverse reactions were compared between the two groups.Results:After extubation,the heart rate(HR),systolic pressure(SBP)and diastolic pressure(DBP)in the two groups increased first and then decreased.The HR,SBP and DBP in the observation group were significantly lower than those in control group at every time points(P<0.05).The postoperative pain VAS score gradually decreased in the two groups,with significant within-group difference observed at each time point(P<0.05).The VAS score in the observation group was higher than that in the control group at every time point(P<0.05).The Ramsay sedation score in the observation group was higher than that in the control group.The incidence rate and severity of agitation were lower than those in control group(P<0.05).There was no significant difference in the occurrence of adverse reactions after anesthesia recovery between the two groups(P>0.05).Conclusion:Dezocine combined with ropivacaine for preemptive analgesia in patients undergoing radical mastectomy can effectively improve the analgesic effects,reduce the incidence rate and severity of agitation during anesthesia recovery and maintain hemodynamic stability.It is beneficial to postoperative rehabilitation of patients.