重庆医学
重慶醫學
중경의학
CHONGQING MEDICAL JOURNAL
2014年
10期
1203-1205
,共3页
地佐辛%瑞芬太尼%妇科外科手术%腔镜镜%术后镇痛%麻醉复苏
地佐辛%瑞芬太尼%婦科外科手術%腔鏡鏡%術後鎮痛%痳醉複囌
지좌신%서분태니%부과외과수술%강경경%술후진통%마취복소
dezocine%remifentanil%gynecologic surgical operation%laparoscope%postoperative analgesia%anesthesia recovery
目的:观察术毕前应用地佐辛对妇科腹腔镜手术患者术后复苏的影响及对术后疼痛干预效果。方法将择期腹腔镜下行全子宫切除术患者60例,ASAⅠ~Ⅱ级,分为观察组(应用地佐辛,n=30)和对照组(应用生理盐水,n=30)。瑞芬太尼复合丙泊酚静脉气管内插管全身麻醉,术毕前30~40 min观察组静脉注射地佐辛0.1 mg/kg (生理盐水稀释至10 mL ),对照组注射同容量生理盐水。记录两组患者诱导前、注药后及苏醒前、后的血压、心率(H R )变化,以及复苏时间、复苏期不良反应及术后疼痛发生情况。结果观察组患者苏醒期时的平均动脉压(MAP)升高、HR增快幅度低于对照组(P<0.05);两组患者恢复自主呼吸时间与拔管时间比较,差异无统计学意义(P>0.05)。两组患者苏醒期氧分压(PO2)、二氧化碳分压(PCO2)、血氧饱和度(SaO2)比较,差异无统计学意义(P>0.05);观察组患者术后躁动-镇静评分(PASS)、视觉模拟评分(VAS)明显低于对照组(P<0.05),寒战发生率也低于对照组(P<0.05)。结论妇科腹腔镜手术患者术毕前静脉应用地佐辛,能有效抑制患者苏醒期的心血管应激反应,不影响复苏速度,且能减少苏醒期躁动和术后疼痛。
目的:觀察術畢前應用地佐辛對婦科腹腔鏡手術患者術後複囌的影響及對術後疼痛榦預效果。方法將擇期腹腔鏡下行全子宮切除術患者60例,ASAⅠ~Ⅱ級,分為觀察組(應用地佐辛,n=30)和對照組(應用生理鹽水,n=30)。瑞芬太尼複閤丙泊酚靜脈氣管內插管全身痳醉,術畢前30~40 min觀察組靜脈註射地佐辛0.1 mg/kg (生理鹽水稀釋至10 mL ),對照組註射同容量生理鹽水。記錄兩組患者誘導前、註藥後及囌醒前、後的血壓、心率(H R )變化,以及複囌時間、複囌期不良反應及術後疼痛髮生情況。結果觀察組患者囌醒期時的平均動脈壓(MAP)升高、HR增快幅度低于對照組(P<0.05);兩組患者恢複自主呼吸時間與拔管時間比較,差異無統計學意義(P>0.05)。兩組患者囌醒期氧分壓(PO2)、二氧化碳分壓(PCO2)、血氧飽和度(SaO2)比較,差異無統計學意義(P>0.05);觀察組患者術後躁動-鎮靜評分(PASS)、視覺模擬評分(VAS)明顯低于對照組(P<0.05),寒戰髮生率也低于對照組(P<0.05)。結論婦科腹腔鏡手術患者術畢前靜脈應用地佐辛,能有效抑製患者囌醒期的心血管應激反應,不影響複囌速度,且能減少囌醒期躁動和術後疼痛。
목적:관찰술필전응용지좌신대부과복강경수술환자술후복소적영향급대술후동통간예효과。방법장택기복강경하행전자궁절제술환자60례,ASAⅠ~Ⅱ급,분위관찰조(응용지좌신,n=30)화대조조(응용생리염수,n=30)。서분태니복합병박분정맥기관내삽관전신마취,술필전30~40 min관찰조정맥주사지좌신0.1 mg/kg (생리염수희석지10 mL ),대조조주사동용량생리염수。기록량조환자유도전、주약후급소성전、후적혈압、심솔(H R )변화,이급복소시간、복소기불량반응급술후동통발생정황。결과관찰조환자소성기시적평균동맥압(MAP)승고、HR증쾌폭도저우대조조(P<0.05);량조환자회복자주호흡시간여발관시간비교,차이무통계학의의(P>0.05)。량조환자소성기양분압(PO2)、이양화탄분압(PCO2)、혈양포화도(SaO2)비교,차이무통계학의의(P>0.05);관찰조환자술후조동-진정평분(PASS)、시각모의평분(VAS)명현저우대조조(P<0.05),한전발생솔야저우대조조(P<0.05)。결론부과복강경수술환자술필전정맥응용지좌신,능유효억제환자소성기적심혈관응격반응,불영향복소속도,차능감소소성기조동화술후동통。
Objective To observe the influence of dezocine used before end of operation on postoperative recovery and its inter-vention effect on postoperative pain in the patients with gynecological laparoscopic operation .Methods 60 patients(ASA Ⅰ - Ⅱ ) scheduled hysterectomy operation by gynecological laparoscopy were randomly divided into the observation group (dezocine group , n=30) and the control group(normal saline group ,n=30) .Remifentanil combined with propofol was intravenously given for con-ducting endotracheal intubation general anesthesia .The observation group was given dezocine 0 .1mg/kg(diluting to 10mL by nor-mal saline) at 30-40 min before the end of operation ,while the control group was given the same volume of physiological saline . Blood pressure ,heart rate(HR) ,recovery time ,adverse reactions during the recover period and postoperative pain before induction , after injection and before recovery were recorded .Results The elevation of mean arterial pressure(MAP) and the increase of HR during the recovery period in the observation group were lower than those in the control group (P<0 .05);the recovery time of au-tonomous respiration and extubation time had no statistical difference between the two groups (P>0 .05) .PO2 ,PCO2 and SaO2 had no statistical difference between the two groups (P>0 .05);the postoperative agitation-sedation scores(PASS) and the visual ana-logue scale(VAS) scores in the observation group were significantly lower than those in the control group (P<0 .05) ,and the oc-currence rate of chills also was lower than that in the control group (P<0 .05) .Conclusion Intravenous dezocine before the end of operation in the gynecological laparoscopic operation can effectively inhibit the cardiovascular stress reaction ,does not affect the re-covery speed ,moreover can decrease the restlessness during the recovery period and postoperative pain .