CAJ | 학술논문

目的：观察地佐辛与舒芬太尼静脉辅助用药对预防腰硬联合阻滞麻醉下全子宫切除术中牵拉反应的作用及不良反应。方法将ASA分级Ⅰ-Ⅱ级、拟于腰硬联合阻滞麻醉下行子宫肌瘤全子宫切除术的患者60例随机分成三组各20例。切皮前S组静注舒芬太尼10μg，D1组静注地佐辛5mg，D2组静注地佐辛10mg，三组均常规吸氧。记录入室(T1)、给药前(T2)、给药后15min(T3)、打开腹膜时(T4)、探查子宫时(T5)、断子宫韧带时(T6)、擦拭腹腔时(T7)各时间点的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)、Ramsay镇静评分、VAS疼痛评分、内脏牵拉反应评分。结果 S组与D2组患者一般情况比较、Ramsay评分、VAS评分、MAP、HR、SPO2差异无统计学意义(P>0.05)，D1组内脏牵拉反应评分高于S组和D2组(P<0.05)。结论地佐辛与舒芬太尼预防内脏牵拉反应的效果良好，且作用相当，但地佐辛的恶心、呕吐、呼吸抑制等不良反应少。
목적：관찰지좌신여서분태니정맥보조용약대예방요경연합조체마취하전자궁절제술중견랍반응적작용급불량반응。방법장ASA분급Ⅰ-Ⅱ급、의우요경연합조체마취하행자궁기류전자궁절제술적환자60례수궤분성삼조각20례。절피전S조정주서분태니10μg，D1조정주지좌신5mg，D2조정주지좌신10mg，삼조균상규흡양。기록입실(T1)、급약전(T2)、급약후15min(T3)、타개복막시(T4)、탐사자궁시(T5)、단자궁인대시(T6)、찰식복강시(T7)각시간점적평균동맥압(MAP)、심솔(HR)、혈양포화도(SpO2)、Ramsay진정평분、VAS동통평분、내장견랍반응평분。결과 S조여D2조환자일반정황비교、Ramsay평분、VAS평분、MAP、HR、SPO2차이무통계학의의(P>0.05)，D1조내장견랍반응평분고우S조화D2조(P<0.05)。결론지좌신여서분태니예방내장견랍반응적효과량호，차작용상당，단지좌신적악심、구토、호흡억제등불량반응소。
Objective To investigate the prevention effects of intravenous dezocine and sufentanil on visceral traction reaction during hysterectomy under the spinal-epidural anesthesia. Methods Sixty ASAⅠ -Ⅱpatients, scheduled for hysterectomy under the spinal-epidural anesthesia, were randomly divided into three groups(n=20): sufentanil 10μg(S group), dezocine 5mg(D1 group) and dezocine 10mg(D2 group). MAP, HR, SpO2, Ramsay sedation score, VAS pain score and visceral traction reaction were recorded separately at different time points as follows: Baseline(T1), before administration(T2), 15 minutes after administration(T3), to open the peritoneum(T4), when the uterus probe(T5), breaking the uterine ligaments(T6), wipe the abdominal cavity(T7). Results S group and D2 group of patients with relatively normal circumstances, Ramsay score, VAS score, MAP, HR,and SPO2 was no significant difference(P>0.05), D1 group visceral reaction score higher than S and D2 group(P<0.05). Conclusion Dezocine 10 mg IV is as effective as sufentanil in preventing visceral reaction during hysterectomy, with less incidence of nausea, vomiting and respiratory depression.