地佐辛联合依托咪酯对麻醉手术患者镇痛和术中应激及苏醒质量的影响

Effects of dezocine combined with etomidate on analgesia and intraoperative stress and quality of recovery in anesthesia patients

目的探讨地佐辛联合依托咪酯对麻醉手术患者镇痛、术中应激及苏醒质量的影响。方法选取2020年12月至2021年12月于德兴市人民医院拟行麻醉手术的80例患者作为研究对象,按照随机数字表法分为地佐辛(DE)组和地佐辛联合依托咪酯(DB)组,各40例。DE组予以地佐辛麻醉,DB组予以地佐辛联合依托咪酯麻醉,比较两组不同时间血流动力学指标、疼痛程度、术中应激指标及苏醒质量、不良反应发生率。结果T0时,两组平均动脉压(MAP)、心率(HR)水平比较差异无统计学意义;T1~T5时,DB组MAP水平均高于DE组,T1~T4时DB组HR均快于DE组,差异有统计学意义(P<0.05);T5时,两组HR比较差异无统计学意义。T0~T3时,两组视觉模拟评分法(VAS)评分比较差异无统计学意义;T4~T5时,DB组VAS评分均低于DE组,差异有统计学意义(P<0.05)。T0时,两组皮质醇(Cor)、促肾上腺皮质激素(ACTH)水平比较差异无统计学意义;T1~T3时,两组Cor、ACTH水平均明显高于前一时间点,但DB组低于DE组,差异有统计学意义(P<0.05)。DB组Ramsay镇静评分高于DE组,躁动评分低于DE组,苏醒时间、拔管时间均短于DE组,差异有统计学意义(P<0.05);DB组不良反应发生率低于DE组,差异有统计学意义(P<0.05)。结论地佐辛联合依托咪酯对麻醉手术患者具有良好的镇痛作用,可维持血流动力学稳定,有效改善术中应激反应及苏醒质量,且安全性较高。

Objective To investigate the effects of dezocine combined with etomidate on analgesia,intraoperative stress and recovery quality of anesthesia patients.Methods 80 patients who planned to undergo anesthesia operation in Dexing People's Hospital from December 2020 to December 2021 were selected as the study subjects,and they were divided into the dezocine(DE)group and the dezocine combined with etomidate(DB)group according to random number table method,with 40 cases in each group.The hemodynamic indexes,pain degree,intraoperative stress indexes at different time and recovery quality and incidence of adverse reactions were compared between the two groups.Results At T0,there was no significant difference in mean arterial pressure(MAP)and heart rate(HR)levels between the two groups;at T1 to T5,MAP level in the DB group was higher than that in the DE group,at T1 to T4,HR in the DB group was faster than that in the DE group,and the differences were statistically significant(P<0.05);at T5,there was no significant difference in HR between the two groups.At T0 to T3,there was no significant difference in visual analogue scale(VAS)score between the two groups;at T4 to T5,VAS scores in the DB group were lower than those in the DE group,the differences were statistically significant(P<0.05).At T0,there was no significant difference in Cor and ACTH levels between the two groups;at T1 to T3,cortisol(Cor)and adrenocorticotropic hormone(ACTH)levels of the two groups were significantly higher than the previous time point,but the DB group was lower than the DE group,the differences were statistically significant(P<0.05).Ramsay sedation score in the DB group was higher than the DE group,agitation score was lower than the DE group,recovery time and extubation time were shorter than the DE group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the DB group was lower than that in the DE group,the difference was statistically significant(P<0.05).Conclusion Dezocine combined with etomidate has good analgesic effect on anesthesia patients,can maintain hemodynamic stability,and can effectively improve intraoperative stress response and quality of recovery,and has high safety.