超前应用地佐辛在瑞芬太尼复合全身麻醉的老年患者中效果评价

Evaluation of the efficacy of preemptive Dezocine in elderly patients undergoing Remifentanil combined with general anesthesia

目的研究超前应用地佐辛在瑞芬太尼复合全身麻醉在老年患者中对麻醉效果的影响。方法选择2018年1月至2019年12月期间在我院行瑞芬太尼复合全身麻醉的老年患者132例,根据患者不同手术类型方式分为对照组及观察组,每组66例。对照组患者采用瑞芬太尼复合全身麻醉,观察组在对照组的基础,上超前应用地佐辛。对比两组患者苏醒期躁动发生率,不良反应发生率,苏醒时间、拔管时间以及两组患者术后的各项生命体征。结果观察组患者苏醒期躁动率和不良反应发生率分别为6.1%(4/66)、4.6%(3/66),对照组分别为27.3%(18/66)、19.7%(13/66),组间差异有统计学意义(χ^2=10.69和7.11,P=0.00和0.01);观察组患者苏醒时间和拔管时间均短于对照组(均P<0.05);观察组患者拔管0.5 h后,心率、视觉模拟疼痛评分均低于对照组,而血氧饱和度评分均高于对照组(均P<0.05)。结论行瑞芬太尼复合全身麻醉的老年患者超前应用地佐辛可以有效地缓解患者苏醒期躁动发生率,降低不良反应发生率,有助于患者术后苏醒,缩短拔管时间,有助于患者心率和血压的稳定,具有较高的临床推广价值。

Objective To investigate the anesthetic effect of preemptive Dezocine in elderly patients undergoing Remifentanil combined with general anesthesia.Methods A total of 132 elderly patients undergone Remifentanil combined with general anesthesia in our hospital from January 2018 to January 2019 were enrolled.According to different anesthesia methods,patients were divided into a control group and an observation group(n=66 for each group).Patients in the control group only received Remifentanil combined with general anesthesia and patients in the observation group were additionally given preemptive dezocine.The incidence of restlessness during the recovery period,the incidence of adverse reactions,recovery time,extubation time and levels of various vital signs were compared between the two groups.Results The incidences of agitation and adverse reactions were 6.1%(4/66)and 4.6%(3/66)in the observation group and 27.3%(18/66)and 19.7%(13/66)in the control group,respectively,with statistically significant differences between the groups(χ^2=10.69 and 7.11,P=0.00 and 0.01).The recovery time and extubation time were shorter in the observation group than in the control group(P<0.05).After 0.5 h of extubation,the heart rate and visual analog pain score(VAS)were lower and oxygen saturation(Sp02)was higher in the observation group than in the control group(P<0.05).Conclusions Preemptive Dezocine in elderly patients undergoing Remifentanil combined with general anesthesia can effectively alleviate agitation during the recovery period,reduce the incidence of adverse reactions,help patients wake up after surgery,shorten the time of extubation,and stabilize patients’heart rate and blood pressure.Therefore,its clinical use should be recommended.