CAJ | 학술논문

目的观察地佐辛不同给药时机对腹腔镜下胆囊切除术全麻苏醒期间躁动的影响。方法选择90例ASA 1～2级需要在全麻下行腹腔镜下胆囊切除术的患者，随机分为三组。A组：30例，全麻诱导前静注地佐辛0.1mg/kg。B组：30例，手术开始下刀后静注地佐辛0.1mg/kg。C组：30例，手术结束停药时静注地佐辛0.1mg/kg。三组麻醉诱导及麻醉维持方法均相同。分别纪录麻醉前患者的呼吸次数，麻醉持续时间、自主呼吸恢复时间、拔管时间、拔管时镇静-躁动（RASS）评分及拔管5min后的呼吸次数。结果三组患者麻醉持续时间及拔管5min后的呼吸次数均差异无显著性（P>0.05）。A组与B组之间自主呼吸恢复时间、拔管时间均差异无显著性（P>0.05）， A组和B组与C组之间自主呼吸恢复时间、拔管时间均差异有显著性（P<0.05），A组和B组比C组自主呼吸恢复时间及拔管时间较短。三组之间拔管时镇静-躁动（RASS）评分均差异有显著性（P<0.05），A组镇静和预防躁动效果均不明显，B组预防躁动效果明显，C组镇静效果明显。结论手术开始下刀后静注地佐辛能够有效减少腹腔镜胆囊切除术术后全麻苏醒期躁动的发生，并且不影响全麻的复苏。
목적관찰지좌신불동급약시궤대복강경하담낭절제술전마소성기간조동적영향。방법선택90례ASA 1～2급수요재전마하행복강경하담낭절제술적환자，수궤분위삼조。A조：30례，전마유도전정주지좌신0.1mg/kg。B조：30례，수술개시하도후정주지좌신0.1mg/kg。C조：30례，수술결속정약시정주지좌신0.1mg/kg。삼조마취유도급마취유지방법균상동。분별기록마취전환자적호흡차수，마취지속시간、자주호흡회복시간、발관시간、발관시진정-조동（RASS）평분급발관5min후적호흡차수。결과삼조환자마취지속시간급발관5min후적호흡차수균차이무현저성（P>0.05）。A조여B조지간자주호흡회복시간、발관시간균차이무현저성（P>0.05）， A조화B조여C조지간자주호흡회복시간、발관시간균차이유현저성（P<0.05），A조화B조비C조자주호흡회복시간급발관시간교단。삼조지간발관시진정-조동（RASS）평분균차이유현저성（P<0.05），A조진정화예방조동효과균불명현，B조예방조동효과명현，C조진정효과명현。결론수술개시하도후정주지좌신능구유효감소복강경담낭절제술술후전마소성기조동적발생，병차불영향전마적복소。
Objective To observe the effect of dezocine at different intravenous injection time to prevent the agitation during recovery period from general anesthesia in the laparoscopic operation. Methods 90 patients of ASA 1~2 undergoing the general anesthesia in the laparoscopic operation were divided into three groups randomly. Group A were injected dezocine with 0.1mg/kg before the anesthesia induction. Group B were injected dezocine with 0.1mg/kg at the beginning of the operation. Group C were injected dezocine with 0.1mg/kg at the end of the operation. The respiration rate before anesthesia, the time of anesthetic maintainence, the recovery time of the autonomous respiration, the extubation time, Richmond Agitation-Sedation Scale(RASS) and the respiration rate 5 minute after the extubation were observed and recorded respectively among the three groups. Results No significantly differences of the anesthetic maintainence time and the respiration rate 5 minute after the extubation were found(all P>0.05) among the three groups . There is no obvious differences of the recovery time of the autonomous respiration and the extubation time in group A and group B(P>0.05). The recovery time of the autonomous respiration and the extubation time was obviously different among the three groups(P<0.05). which in group A and group B were much shorter than group C. Also the extubation RASS scores were different in the three groups(all P<0.05). The effect of the sedation scale and the anti-agitation in group A were not obvious. The effect of anti-agitation in group B were obvious. The effect of the sedation scale in group C were significant. Conclusion To intravenous inject the dezocine at the beginning of the laparoscopic operation can effectively decrease the agitation rate during Recovery Period from General Anesthesia without increase the recovering time