Effects of Dezocine and Propofol Combination on Plasma 5-HT and ET Levels in Stroke Patients Undergoing Thrombolysis

Objective: To investigate the effect of dezocine combined with propofol on brain metabolism in patients undergoing cerebral thrombosis thrombolysis. Methods: A total of 86 stroke patients admitted between July 2022 and December 2023 were randomly divided into two groups: Group A (study group) and Group B (control group), with 43 patients in each group. Both groups underwent intra-arterial thrombolysis therapy. Group B received dezocine for anesthesia, while Group A received a combination of dezocine and propofol. Plasma concentrations of 5-hydroxytryptamine and endothelin, as well as brain metabolic indicators, were compared between the two groups immediately after anesthesia, at 1 hour post-reperfusion, and 3 hours post-reperfusion. Results: There were no significant differences in the levels of 5-hydroxytryptamine and endothelin between the two groups immediately after anesthesia and at 1 hour post-reperfusion (P > 0.05). However, at 3 hours post-reperfusion, the levels of 5-hydroxytryptamine and endothelin in Group A were significantly lower than those in Group B. Furthermore, in Group A, the levels of 5-hydroxytryptamine and endothelin at 3 hours post-reperfusion were lower compared to the levels at 1 hour post-reperfusion (P < 0.05). Conclusion: Dezocine combined with propofol can effectively improve the quality of anesthesia and has a minimal effect on brain metabolic indices, suggesting reduced damage to brain metabolism.

Clinical study of anesthetization by dezocine combined with propofol for indolent colonoscopy

AIM: To assess the use of dezocine combined with propofol for the anesthetization of patients undergoing indolent colonoscopy.METHODS: A cross-sectional survey of patients undergoing indolent colonoscopy in the Xinjiang people's Hospital was conducted from April 1 to April 30, 2015. The survey collected patient general information and anesthesia data, including overall medical experience and pain management. Thirty minutes after colonoscopy surgery, samples of venous blood were collected and the biochemical indicators of gastrointestinal function were analyzed. RESULTS: There were 98 female and 62 male respondents. Indolent colonoscopy was found to be more suitable for mid to older-aged patients. The necessary conditions for the diagnosis of digestive diseases were required in 65 of the 73 inpatients. Adverse reactions to the intraoperative process included two cases of body movement and two cases of respiratory depression. Gastrin and vasoactive intestinal peptide levels were slightly increased. However, somatostatin and endothelin levels were slightly decreased. CONCLUSION: This study revealed that dezocine combined with propofol can be successfully used for the anesthetization of indolent colonoscopy patients without pain and should be widely used.

Combination of propofol and dezocine to improve safety and efficacy of anesthesia for gastroscopy and colonoscopy in adults: A randomized, double-blind, controlled trial

BACKGROUND Gastroscopy and colonoscopy are important and common endoscopic methods for the diagnosis and treatment of gastrointestinal and colorectal diseases.However,endoscopy is usually associated with adverse reactions such as nervousness,nausea,vomiting,choking cough,and pain.Severe discomfort,such as vomiting,coughing,or body movement,may lead to aggravation of a preexisting condition or even interruption of examination or treatment,especially in some critically ill patients with physiological dysfunction(e.g.,cardiovascular or respiratory disease).The optimal methods for inducing analgesia and sedation in endoscopy are areas of ongoing debate;nevertheless,determining an appropriate regimen of sedation and analgesia is important.AIM To evaluate the effects of propofol combined with dezocine,sufentanil,or fentanyl in painless gastroscopy and colonoscopy.METHODS Four hundred patients were randomly assigned to one of four groups for anesthesia:intravenous dezocine,sufentanil,fentanyl,or saline.Propofol was administered intravenously for induction and maintenance of anesthesia.RESULTS The dosage of propofol in the dezocine group was significantly lower than those in other groups(P<0.01).Bispectral index and Steward score(0-6 points,an unresponsive,immobile patient whose airway requires maintenance to a fully recovered patient)after eye opening in the dezocine group were significantly higher than those in other groups(P<0.01).Awakening time and postoperative pain score(0-10 points,no pain to unbearable pain)in the dezocine group were significantly lower than those in other groups(P<0.01).Mean arterial pressure and pulse oxygen saturation in the dezocine group were significantly more stable at various time points(before dosing,disappearance of eyelash reflex,and wakeup)than those in other groups(P<0.01).The rates of hypopnea,jaw thrust,body movements,and usage of vasoactive drugs in the dezocine group were significantly lower than those in other groups(P<0.01).Additionally,the rates of reflex coughing,nausea,and vomiting were not statistically different between the four groups(P>0.05).CONCLUSION The combination of propofol and dezocine can decrease propofol dosage,reduce the risk for the development of inhibitory effects on the respiratory and cardiovascular systems,increase analgesic effect,decrease body movement,shorten awakening time,and improve awakening quality.

Preoperative administration of intramuscular dezocine reduces postoperative pain for laparoscopic cholecystectomy

Postoperative pain is the most common complaint after laparoscopic cholecystectomy. This study was carried out to evaluate whether preoperative administration of intramuscular dezocine can provide postoperative analgesia and reduce postoperative opioid consumption in patients undergoing laparoscopic cholecystectomy. Patients （ASA Ⅰ or Ⅱ ） scheduled for laparoscopic cholecystectomy were randomly assigned into intramuscular dezocine group （group 1） or intramuscular normal saline group （group 2）. Dezocine and equal volume normal saline were administered intramuscularly 10 rain before the induction of anesthesia. After operation, the severity of postoperative pain, postoperative fentanyl requirement, incidence and severity of side-effects were assessed. Postoperative pain and postoperative patient-controlled fentanyl consumption were reduced significantly in group l compared with group 2. The incidence and severity of side effects were similar between the two groups. Preoperative single-dose administration of intramuscular dezocine 0.1 mg/kg was effective in reducing postoperative pain and postoperative patient-controlled fentanyl requirement in patients undergoing laparoscopic cholecystectomy.

Study on the Clinical Effect of Dezocine and Remifentanil Combined with Propofol in Anesthesia for Painless Abortion

Objective:To investigate the anesthetic effect of dezocine and remifentanil combined with propofol in painless artificial abortion.Methods:90 cases in total of painlessinduced abortion 1n our hospital from May 2017to May 2020 were retrospectively analyzed,29cases of propofol anesthesia(group A),29cases of dezocine combined with propofol anesthesia(group B),and 32 cases of remifentanil combined with propofol anesthesia(group C)were compared the anesthesia situation.Resuits:Compared with the cases in group A,the incidence of pain,body movement and sPo,90oat the injection site were lower in group B and group C,the use of propofol was reduced,and the VAS scores were lower when the patients begin to awake,and the efficiency was higher than that in group A(P<0.05);there was no statistic difference in the changes of SBP,DBP and HR index data in the operation time,postoperative awake time,and preoperative,intraoperative and postoperative time points of the three groups(P<0.05).Conclusion:Dezocine and remifentamil combined with propofol for painless artificial abortion anesthesia has more significant effect than propofol anesthesia alone,which can relieve patients'pain and reduce the chance of respiratory depression.

Effects of dezocine on postoperative stress response and immune function in patients with breast cancer

Objective: To investigate the effects of dezocine on postoperative stress response and immune function in patients with breast cancer. Methods: According to random data table method, a total of 80 patients who were scheduled for breast cancer radical surgery from September 2016 to May 2017 were divided into observation group and the control group, 40 cases in each group. The observation group gave intravenous injection of dezocine as an advanced analgesia 15 min before anesthesia induction, the control group given the same amount of sodium chloride injection. The levels of serum inflammatory factors and immune function were measured and compared between the two groups before and after operation. Results: The levels of angiotensin Ⅱ, renin, cortisol, aldosterone, CD3+, CD4+, CD8+and CD4+/CD8+ in the two groups before treatment were not statistically significant. The levels of angiotensin Ⅱ, renin, cortisol, aldosterone in the two groups were increased at first and then decreased, which were significantly higher than those in the same group before operation at 1 d and 3 d;and the levels of angiotensin Ⅱ, renin, cortisol, aldosterone in the observation group were significantly lower than those in the control group after 1 d and 3 d, the difference was statistically significant. The levels of serum CD3+, CD4+ and CD4+/CD8+ in the two groups were decreased at first and then increased, which were significantly lower than those in the same group before operation at 1 d and 3 d;and the observation group levels were significantly higher than those in the control group after 1 d and 3 d, the above indicators were compared with the difference was statistically significant. The levels of serum CD8+ in the two groups were increased at first and decreased subquently, which were significantly higher than those in the same group before operation at 1 d and 3 d and the observation group levels were significantly lower than those in the control group after 1 d and 3 d, the above indicators were compared with the difference was statistically significant. The above indicators have restore to preoperative levels after 5 d. Conclusion: Dezocine can reduce the stress response in patients with perioperative breast cancer, improve the immune function of patients, which has important clinical value, so it is worth promoting.

The Applications of Dexmedetomidine Given Composite Dezocine Spinal Anesthesia in Patients Undergoing Total Hip Replacement Surgery

Objective:Objective:To evaluate the applications of dexmedetomidine given composite dezocine spinal anesthesia in patients undergoing total hip replacement surgery.Methods:120 cases ASAⅠ~Ⅱgrade elective surgery THA patients were divided into group A(n=40),group B(n=40),C group(n=40)from June 2015 to June 2016.Group A were routined with endotracheal intubation operation;Group B were gap into the line L2-3 spinal anesthesia,anesthesia after a fixed pumping 0.2 mg dezocine a mixture of 3 ml;Group C were threatmented with dextrose infusion 3μg Mi Ding mixture 3.5 ml.The levels of mean arterial pressure(MAP),heart rate(HR),oxygen saturation(SPO2),endtidal carbon dioxide(PETCO2)and other hemodynamic parameters and plasma epinephrine(E),norepinephrine(NE),malondialdehyde(MDA)of three groups before and after 10 min of anesthesia 5min(T0),of anesthesia(T1),at the start of surgery(T2),1 Xiaoshi(T3)after completion of anesthesia,the end of the surgery(T4).The anesthetic complications occur of three groups were compared.Results:The levels of MAP,HR,SPO2,PETCO2,E,NE,MDA in T1~T4 time were increased than T0 stage(P<0.05).The levels of MAP,HR,SPO2,PETCO2,E,NE,MDA in T1~T4 time of Groups A were increased than Groups B,Group C(P<0.05).The levels of MAP,HR,SPO2,PETCO2,E,NE,MDA in T1~T4 time of Groups A and Groups B were compared.The cognitive disorders,nausea,vomiting,restlessness,chills,a high incidence of respiratory depression of Group A were higher than Group B,Group C(P<0.05),will high incidence of respiratory depression of Group B were higher than Groups C(P<0.05).Conclusion:dexmedetomidine given composite dezocine spinal anesthesia can effectively stabilize hemodynamics THA patients and reduce patient stress and blood vessels,its low incidence of postoperative complications,worthy of promotion application.

Effects of dezocine on cardiovascular response, stress response and cellular immune function before anesthesia induction in radical mastectomy for breast cancer

Objective: To investigate the effects of dezocine on cardiovascular response, stress response and cellular immune function before anesthesia induction in radical mastectomy for breast cancer. Methods: From January 2014 to January 2018, 220 patients with breast cancer undergoing modified radical mastectomy were randomly divided into observation group (110 cases) and control group (110 cases). The observation group was given dezocine before induction of anesthesia, while the control group was given the same amount of Sodium Chloride Injection. Heart rate (HR), mean arterial pressure (MAP), blood oxygen saturation (SpO2), aldosterone (ALD), renin (REN), cortisol (Cor), angiotensin Ⅱ (Ang-Ⅱ) and the level of T cell subsets at 5 time points before anesthesia (T1), 2 h after operation (T2), 10 hours (T3), 24 h (T4) and 48 h (T5) after operation were compared between the two groups. Results:There was no significant difference in HR and MAP between the two groups before anesthesia (30 min). HR and MAP of the two groups were higher at 2 h after operation and 10 h after operation than before, and the HR and MAP of the control group were higher than those of the observation group. There was no significant difference in ALD, REN, Cor and Ang-Ⅱ between the two groups at 30 min before anesthesia and 48 h after operation. ALD, REN, Cor and Ang-Ⅱ in the two groups at 2 h after operation and 10 h, 24 h after operation were higher than those at the 30 min before anesthesia, and ALD, REN, Cor and Ang-Ⅱ in the control group were higher than those in the observation group. There was no significant difference in CD3+, CD4+, CD4+/ CD8+ between the two groups at 30 min before anesthesia and 48 h after operation. CD3+, CD4+, CD4+/CD8+ in the two groups at 2 h after operation and 10 h, 24 h after operation were lower than those at the 30 min before anesthesia, and CD3+, CD4+, CD4+/CD8+ in the control group were lower than those in the observation group. Conclusion: Dezocine before anesthesia induction in radical mastectomy can effectively reduce cardiovascular response and stress response, and play a protective role in cellular immune function.

Effects of dexmedetomidine combined with dezocine on tumor factors, immune function levels and related serum factors in patients with laparoscopic surgery for ovarian cancer

Objective:To study the effects of dexmedetomidine combined with dezocine on tumor factors, immune function levels and related serum factors in patients with laparoscopic surgery for ovarian cancer.Methods: To select 120 cases of laparoscopic ovarian cancer treated and planned to undergo laparoscopic radical operation in our hospital were randomly and equally divided into control group and treatment group. The patients in control group were treated with dezocine, the treatment group were treated with dexmedetomidine combined with dezocine. To detect and compare the serum HE4, YKL-40, TSGF, NSE, S100β protein, MDA, SOD and peripheral blood CD3+, CD4+, CD8+ and calculate CD4+/CD8+ before and after operation. Results: Before the surgery, there was no significant difference in serum HE4, YKL-40, TSGF, NSE, S100β protein, MDA and SOD between the two groups(P>0.05). After surgery, there were significant differences between the two groups in serum HE4, YKL-40, TSGF, NSE, S100β protein, MDA and SOD levels and the same group before surgery (P<0.05), the improvement of each index in the treatment group was better than those in the control group, and the differences were significantly (P<0.05). Before the surgery, the differences between the two groups in peripheral blood CD3+, CD4+, CD8+ and CD4+/CD8+ had no significant difference (P>0.05), After surgery, the differences between the two groups and the same group before operation in peripheral blood CD3+, CD4+, CD8+ levels and CD4+/CD8+ were significantly (P<0.05), the improvement of each index in the treatment group was better than that in the control group, the differences were significantly (P<0.05).Conclusion:Dexmedetomidine combined with dezocine can reduce the serum HE4, YKL-40, TSGF, NSE, S100β protein levels in patients with ovarian cancer after laparoscopic operation, reduce the oxidative stress reaction, has smaller effect on cellular immune function.

Effect of dezocine pretreatment on emergence agitation and relatedinternal environment changes in children with general anesthesia surgery

Objective:To study the effect of dezocine pretreatment on the emergence agitation and related internal environment changes in children with general anesthesia surgery.Methods: A total of 200 children who underwent general anesthesia surgery in the Central Hospital of Xiaogan between January 2015 and December 2017 were enrolled in the study and divided into two groups by random number table method, dezocine group received routine general anesthesia and intravenous injection of dezocine 30 min before the end of surgery, and control group received routine general anesthesia and intravenous injection of saline 30 min before the end of surgery. The CHEPOS score of emergence agitation was performed during anesthesia recovery;the levels of inflammatory stress mediators in serum as well as the expression of stress signal molecules and inflammatory signal molecules in peripheral blood were measured before anesthesia induction and during anesthesia recovery.Results: The CHEPOS score of emergence agitation of dezocine group was lower than that of control group;compared with those of same group before anesthesia induction, serum ACTH, Cor, INS, ICAM1 and TNF-α levels as well as peripheral blood CHOP, GRP78, JNK, c-jun, CD14 and SR expression intensity of both groups of patients were significantly higher whereas IRS-1, IRS-2 and PKB expression intensity were significantly lower during anesthesia recovery, and serum ACTH, Cor, INS, ICAM1 and TNF-α levels as well as peripheral blood CHOP, GRP78, JNK, c-jun, CD14 and SR expression intensity of dezocine group during anesthesia recovery were significantly lower than those of control group whereas IRS-1, IRS-2 and PKB expression intensity were significantly higher than those of control group.Conclusions: Dezocine pretreatment has improving effect on the emergence agitation and related internal environment changes in children with general anesthesia surgery.

Comparison of Dezocine and Tropisetron for the Control of Maternal Shivering Undergoing Spinal Anesthesia--A Randomized Double-blind Trail

To compare intravenous Dezocine Tropisetron in reatment of shivering after spinal anesthesia in cesarean. A double-blind trail. From January to June 2014 90 cases elective cesarean under spinal anesthesia randomly divided into three groups of 30, the control group A （Sml saline） given to dezocine （10mg / 5ml） B grou, given tropisetron （5mg / 5ml） C group. The incidence of shivering in groups 46.48%, 31.18%, 60.83% （P = 〈0.01）. Bradycardia is a group （A） 3.3%, the group （B） is 0.0%. Significant differences in other variables （myoclonic seizures and rash） no significant （P = 0.353）. Dezocine and Tropisetron alone can cure shivering effectively for cesarean section after spinal anesthesia.

Effect of dezocine combined with sufentanil patient-controlled intravenous analgesia on general pain and inflammatory mediators after laparoscopic hepatectomy

Objective:To study the effect of dezocine combined with sufentanil patient-controlled intravenous analgesia on general pain and inflammatory mediators after laparoscopic hepatectomy.Methods: A total of 68 patients with primary liver cancer who received laparoscopic surgical treatment in our hospital between July 2014 and December 2016 were collected, the therapies were reviewed, and then patients were divided into the control group (n=35) who received sufentanil PCIA and the observation group (n=33) who received dezocine combined with sufentanil PCIA. Differences in serum levels of pain mediators, acute phase proteins and interleukins were compared between the two groups of patients before and after operation.Results: Before operation, the differences in serum levels of pain mediators, acute phase proteins and interleukins were not statistically significant between the two groups of patients. 6h after operation, serum pain mediators SP, NPY, DA and NE levels in observation group were lower than those in control group;acute phase proteins CRP, HP, CER and AAG levels were lower than those in control group;interleukins IL-1β, IL-6 and IL-8 levels were lower than those in control group.Conclusion: Dezocine combined with sufentanil PCIA after laparoscopic hepatectomy is effective in reducing the early postoperative pain mediator levels and relieving systemic inflammatory response.

地佐辛静脉麻醉联合罗哌卡因局部浸润麻醉镇痛对腹腔镜结直肠癌根治术患者镇痛效果及围术期免疫和应激反应影响

目的探讨腹腔镜结直肠癌根治术患者使用地佐辛静脉麻醉联合罗哌卡因局部浸润麻醉镇痛效果及对围术期免疫和应激反应影响。方法选取2020年4月—2022年5月择期行腹腔镜结直肠癌根治术患者100例,据麻醉镇痛方式不同均分为观察组和对照组,观察组给予全麻及地佐辛静脉麻醉联合罗哌卡因局部浸润麻醉镇痛,对照组给予全麻及罗哌卡因局部浸润麻醉镇痛。记录2组麻醉诱导前5 min(T0)、术毕(T1)、拔管即刻(T2)、拔管后30 min(T3)、拔管后60 min(T4)时平均动脉压(MAP)、心率(HR)及血清皮质醇(Cor)、丙二醛(MDA)水平;比较术前、术后24 h 2组外周血CD4+、CD8+和CD4+/CD8+水平,术毕12、24、48 h视觉模拟评分法(VAS)评分,术前、术后3 d简易智力状态检查量表(MMSE)评分,以及2组麻醉恢复期间不良反应。结果T3时,2组MAP、HR高于T0时,且观察组低于对照组(P<0.05);T1、T2、T3、T4时,2组Cor、MDA均高于T0时,且观察组低于对照组(P<0.05)。术后24 h,2组CD4+、CD4+/CD8+降低,CD8+升高,且观察组CD4+、CD4+/CD8+较对照组升高,CD8+较对照组降低(P<0.05)。观察组术毕12、24、48 h VAS评分均较对照组降低(P<0.05)。术后3 d,2组MMSE评分均降低,且观察组低于对照组(P<0.05)。观察组麻醉恢复期间躁动发生率为6.00%(3/50)低于对照组的20.00%(10/50)(P<0.05)。结论全麻及地佐辛静脉联合罗哌卡因局部浸润麻醉镇痛对腹腔镜结直肠癌根治术患者免疫功能影响小,可减轻手术应激,镇痛效果好,且安全性高。

地佐辛超前镇痛联合头皮神经阻滞对血肿清除术治疗高血压脑出血患者的影响

目的分析地佐辛超前镇痛联合头皮神经阻滞(scalp nerve block,SNB)在高血压脑出血(hypertensive intracerebral hemorrhage,HICH)患者手术治疗的应用效果。方法 使用随机数表法将手术治疗的76例HICH患者均分为对照组和观察组。对照组在常规全身麻醉基础上给予SNB麻醉,观察组在对照组基础上给予地佐辛超前镇痛。比较两组术前、切皮、穿刺颅骨、缝皮时的平均动脉压(mean arterial pressure,MAP)、心率;比较两组清醒拔管时、术后6h、12h、24h、48h时的视觉模拟评分法(visual analogue scale,VAS)疼痛评分;统计两组麻醉相关不良反应发生率。结果 对照组切皮、穿刺颅骨、缝皮时的MAP、心率水平均高于术前,观察组切皮、穿刺颅骨、缝皮时的MAP、心率水平均低于对照组(P<0.001)。观察组术后6h、12h、24h、48h时的VAS评分均较对照组更低(P<0.001)。观察组不良反应发生率为5.26%,对照组为23.68%,观察组低于对照组(P<0.05)。结论 地佐辛超前镇痛联合SNB应用于HICH患者手术治疗,不仅可有效维持患者围术期血流动力学稳定,还可减轻患者术后疼痛,提高麻醉安全性。

地佐辛联合丙泊酚麻醉在胃癌根治术患者中的应用效果

目的:观察地佐辛联合丙泊酚麻醉在胃癌根治术患者中的应用效果。方法:选取2019年5月至2022年5月该院收治的92例胃癌根治术患者进行前瞻性研究,按照随机数字表法将其分为对照组与观察组各46例。对照组采用芬太尼联合丙泊酚麻醉,观察组采用地佐辛联合丙泊酚麻醉,比较两组不同时间[麻醉诱导前(T_(0))、术后0.5 h(T_(1))、术毕(T_(2))]血流动力学指标[平均动脉压(MAP)、心率]水平,手术前后应激反应指标(皮质醇、促肾上腺皮质激素)水平、认知功能[简易精神状态检查量表(MMSE)]评分,以及不良反应发生率。结果:T_(0)、T_(1)、T_(2)时,两组MAP、心率呈先降低后升高的趋势,T_(0)、T_(2)时,两组MAP、心率水平比较,差异均无统计学意义(P>0.05);T_(1)时,观察组心率、MAP水平均高于对照组,差异有统计学意义(P<0.05);术后24 h,两组皮质醇、促肾上腺皮质激素水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);术后24 h,两组MMSE评分均低于术前,但观察组高于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论:地佐辛联合丙泊酚麻醉可提高胃癌根治术患者认知功能评分和血流动力学指标水平,降低应激反应指标水平和不良反应发生率,其效果优于芬太尼联合丙泊酚麻醉。

地佐辛通过调节氧化应激水平改善对老年骨折患者围术期神经认知障碍的作用

目的探讨地佐辛对老年围术期神经认知的影响及可能机制。方法选取60例股骨骨折需行手术治疗的老年患者,采用随机数字表法分为地佐辛组(Dez组)及氯化钠组(NS组)各30例,记录患者入室时(T0)、手术结束时(T1)的生命体征变化,测定阻滞平面,并记录平面至T10、T8的时间。在T0、T1、手术后24 h(T2)采取外周静脉血检测皮质醇、C反应蛋白(CRP)、超氧化物歧化酶(SOD)及丙二醛(MDA)表达水平。在术前1天、术后第1天及第7天采用简易精神状态评价量表进行围术期神经认知障碍的评估。结果与NS组比较,Dez组患者T1、T2时皮质醇、CRP、SOD表达增高而MDA表达较低,差异有统计学意义(P<0.05)。术后1天、7天,与NS比较,Dez组患者围术期神经认知障碍发生率较低(P<0.05)。NS组患者术后1天MMSE评分与皮质醇、SOD表达水平呈正相关(P<0.05)。结论地佐辛在一定程度上抑制术后老年患者氧化应激水平,从而减轻围术期神经认知障碍。

纳布啡复合地佐辛麻醉对髋关节置换术患者认知功能、血液流变学及神经递质的影响

目的探究纳布啡复合地佐辛麻醉对髋关节置换术患者认知功能、血液流变学及神经递质的影响。方法选取2020年1月至2023年1月在九江市柴桑区中医医院行髋关节置换术的82例患者作为研究对象,采用随机数表法分为对照组和观察组各41例。对照组患者予以地佐辛麻醉,观察组患者予以纳布啡复合地佐辛麻醉。比较两组患者手术前后的疼痛程度、认知功能、血液流变学及神经递质水平。结果两组患者术后24 h及48 h的视觉模拟量表(VAS)评分较术前均显著升高,但术后48 h较术后24 h明显降低,且观察组患者术后24 h及48 h的VAS评分分别为(2.07±0.65)分、(1.76±0.58)分,明显低于对照组的(2.78±0.65)分、(2.10±0.54)分,差异均有统计学意义(P<0.05);两组患者术后24 h及48 h的简易精神状态检查量表(MMSE)评分较术前均显著降低,但术后48 h较术后24 h明显升高,且观察组患者术后24 h及48 h的MMSE评分分别为(23.71±2.3)分、(24.88±2.32)分,明显高于对照组的(22.39±1.92)分、(23.61±1.88)分,差异均有统计学意义(P<0.05);两组患者术后纤维蛋白原(FIB)、血浆黏度(PV)、红细胞聚集指数(AI)、红细胞压积(HCT)、中枢神经特异蛋白(S100β)、5-羟色胺(5-HT)、β-内啡肽(β-EP)水平较术前均显著升高,但观察组患者术后的FIB、PV、AI、HCT、S100β、5-HT、β-EP水平分别为(4.14±0.94)g/L、(1.80±0.33)m Pa/s、22.46±5.15、(48.60±5.67)%、(138.62±10.76)pg/mL、(23.99±2.57)μmol/L、(0.57±0.11)pg/mL,明显低于对照组的(4.59±1.01)g/L、(1.98±0.38)mPa/s、24.93±4.30、(51.26±5.55)%、(159.80±15.51)pg/mL、(33.62±6.26)μmol/L、(0.73±0.19)pg/mL,差异均有统计学意义(P<0.05)。结论纳布啡复合地佐辛麻醉可减轻髋关节置换术患者的疼痛感及认知功能障碍,且对血液流变学及神经递质的影响较轻。

地佐辛、喷他佐辛用于胃癌根治术患者术后镇痛的药物经济学评价

目的探讨两种胃癌术后镇痛方案的药物经济学评价。方法回顾性分析2020年10月—2022年9月在某院胃癌根治手术患者162例,按术后镇痛用药的不同分为A组和B组,A组给予地佐辛注射液(76例),B组给予喷他佐辛注射液(86例),统计两组患者的镇痛效果、不良反应、成本等,运用成本-效果分析法进行分析评价。结果安全性方面,A组不良反应发生率为2.63%,B组不良反应发生率为4.65%,差异无统计学意义;疗效方面,各时间段A组疼痛数字评分(NRS)均显著小于B组(P<0.05);A组累计有效率为96.09%,B组累计有效率为70.55%,差异有统计学意义(P<0.05)。药物经济学方面,A组总成本为(969.82±250.76)元,B组总成本为(795.62±108.23)元,A组成本-效果比(C/E)为1010.23,B组C/E为1120.59,增量成本效果比为696.80元,敏感性分析支持成本效果分析。结论胃癌术后镇痛中地佐辛注射液相对于喷他佐辛注射液具有经济学优势。

环泊酚复合地佐辛用于人工流产术麻醉半数有效剂量的测定

目的测定环泊酚复合地佐辛用于人工流产术的半数有效剂量。方法将2023年11月于郑州大学第二附属医院拟行无痛人工流产术的25例患者纳入研究,体重指数为18~25 kg·m^(-2),采用静脉全身麻醉。静脉注射地佐辛2.5 mg后,根据序贯法给予环泊酚,初始剂量0.33 mg·kg^(-1),浓度梯度为0.02 mg·kg^(-1),麻醉后患者眼睑反射消失且宫腔操作5 min内无体动反应,判定为有效(阴性),反之即为无效(阳性),如为阴性环泊酚降低1个浓度梯度,反之升高1个浓度梯度。用Probit概率回归法计算半数有效剂量。结果25例患者中12例阴性,13例阳性。环泊酚复合地佐辛用于无痛人流患者全麻诱导时环泊酚的半数有效剂量为0.346 mg·kg^(-1),95%置信区间为0.322~0.376 mg·kg^(-1)。结论环泊酚复合地佐辛用于无痛人流术患者环泊酚的半数有效剂量为0.346 mg·kg^(-1)。

观察地佐辛与瑞芬太尼复合丙泊酚用于无痛人工流产麻醉中的临床效果

目的 探析地佐辛与瑞芬太尼复合丙泊酚用于无痛人工流产麻醉中的临床效果。方法 选取62例接受无痛人工流产的患者,以随机原则分为对照组及观察组,各31例。对照组选择瑞芬太尼复合丙泊酚麻醉,观察组选择地佐辛复合丙泊酚麻醉。比较两组术后指标[术后疼痛数字评分法(NRS)评分、恢复定向力时间、意识清醒时间],麻醉效果,血流动力学指标[心率(HR)、平均动脉压(MAP)、血氧饱和度(Sp O_(2))],不良反应发生情况。结果 观察组术后NRS评分(2.01±0.53)分低于对照组的(3.11±0.64)分(P<0.05);观察组恢复定向力时间、意识清醒时间与对照组比较,差异无统计学意义(P>0.05)。观察组麻醉效果Ⅰ级27例(87.10%),Ⅱ级3例(9.68%),Ⅲ级1例(3.23%);对照组麻醉效果Ⅰ级20例(64.52%),Ⅱ级6例(19.35%),Ⅲ级5例(16.13%)。观察组麻醉效果优于对照组(Z=2.125,P=0.034<0.05)。术中,观察组HR、MAP、Sp O_(2)分别为(77.21±0.51)次/min、(79.71±0.32)mm Hg(1 mm Hg=0.133 k Pa)、(98.71±0.32)%,高于对照组的(70.22±0.25)次/min、(77.29±0.61)mm Hg、(95.29±0.13)%(P<0.05)。观察组不良反应发生率6.45%低于对照组的25.81%(χ^(2)=4.292,P=0.038<0.05)。结论 与瑞芬太尼复合丙泊酚相比,地佐辛复合丙泊酚用于无痛人工流产整体麻醉效果更佳,可控制不良反应,可选。