CAJ | 학술논문

目的：探讨地佐辛对腹腔镜胆囊切除术全身麻醉苏醒期躁动的影响。方法将择期全身麻醉下行腹腔镜胆囊切除术的60例患者随机分为地佐辛组和对照组各30例。两组患者均予七氟烷、丙泊酚、芬太尼和阿曲库铵麻醉。地佐辛组手术开始后静脉注射地佐辛10 mg，对照组静脉注射同等容量生理盐水。记录患者睁眼时（T1）、拔管时（T2）、拔管后10 min （T3）、30 min （T4）、1 h （T5）、2 h （T6）和3 h （T7）的Riker镇静躁动评分（SAS）和T3、T4、T5、T6和T7的疼痛视觉模拟评分法（VAS）评分；记录芬太尼用量、苏醒时间、拔管时间和术后6 h内恶心及呕吐的发生率。比较两组结果。结果地佐辛组所有时间点的SAS、VAS评分均低于对照组（P＜0.01）；地佐辛组芬太尼用量低于对照组（P＜0.01）；两组苏醒时间、拔管时间和术后6 h内恶心及呕吐发生率比较差异均无统计学意义（P均＞0.05）。结论于手术开始后静脉注射地佐辛10 mg能有效减轻腹腔镜胆囊切除术患者的全身麻醉苏醒期躁动和术后疼痛，并能减少术中阿片类镇痛药物的用量。
목적：탐토지좌신대복강경담낭절제술전신마취소성기조동적영향。방법장택기전신마취하행복강경담낭절제술적60례환자수궤분위지좌신조화대조조각30례。량조환자균여칠불완、병박분、분태니화아곡고안마취。지좌신조수술개시후정맥주사지좌신10 mg，대조조정맥주사동등용량생리염수。기록환자정안시（T1）、발관시（T2）、발관후10 min （T3）、30 min （T4）、1 h （T5）、2 h （T6）화3 h （T7）적Riker진정조동평분（SAS）화T3、T4、T5、T6화T7적동통시각모의평분법（VAS）평분；기록분태니용량、소성시간、발관시간화술후6 h내악심급구토적발생솔。비교량조결과。결과지좌신조소유시간점적SAS、VAS평분균저우대조조（P＜0.01）；지좌신조분태니용량저우대조조（P＜0.01）；량조소성시간、발관시간화술후6 h내악심급구토발생솔비교차이균무통계학의의（P균＞0.05）。결론우수술개시후정맥주사지좌신10 mg능유효감경복강경담낭절제술환자적전신마취소성기조동화술후동통，병능감소술중아편류진통약물적용량。
Objective To evaluate the effect of dezocine 1 0 mg for reducing emergence agitation after general anesthesia in patients undergoing laparoscopic cholecystectomy. Methods Sixty patients scheduled for laparoscopic cholecystectomy were randomly divided into dezocine group(n=30)and control group(n=30).Anesthesia was equally maintained with sevoflurane,propofol,fentanyl and atracurium in both groups. Dezo-cine group received intravenous injection of 1 0 mg dezocine at the beginning of the operation,while control group received intravenous injection of 2 ml normal saline. Riker sedation-agitation scale (SAS)was recorded at eye-opening,extubation,1 5 min,30 min,1 h,2 h and 4 h after extubation,respectively,while VAS was recorded at 1 5 min,30 min,1 h,2 h and 4 h after extubation,respectively. Dosage of fentanyl,awakened time,extubation time and frequency of nausea and vomiting in 6 hours after operation were recorded. The re-sults of two group were compared. Results Compared with control group,SAS and VAS were lower in dezo-cine group at all time points (P<0.01 ),and the dosage of fentanyl was also lower in dezocine group (P<0.01 ). No differences were found within awakened time,extubation time and the frequency of nausea and vom-iting in 6 h after the operation among two groups (P>0.05 ). Conclusion Intravenous injection of 1 0 mg dezocine at the beginning of operation can reduce emergence agitation and postoperative pain in patients under-going laparoscopic cholecystectomy,as well as reduce the demand of intraoperative opioid.