CAJ | 학술논문

目的：观察地佐辛用于小儿全身麻醉下唇腭裂修复术围拔管期的镇痛效果及安全性。方法选择于2013年1月1日至8月1日，在湖北医药学院附属太和医院麻醉科全身麻醉下择期行唇腭裂修复术患儿60例，美国麻醉医师协会（ASA ）Ⅰ～Ⅱ级，分为 D、F、N组，每组20例。所有患儿均实施气管内插管全身麻醉，术毕前15 min D组静脉注射地佐辛0．10 mg/kg ；F组静脉注射芬太尼1．00μg/kg ；N组给予等剂量生理盐水。观察并记录插管前、拔管时、拔管后5 min的平均动脉压（MAP）、心率（HR）；术毕至拔管时间；苏醒期Riker镇静躁动评分；拔管后30 min儿童行为量表疼痛程度（FIACC ）评分及拔管后30 min内各种不良反应（呼吸、循环抑制、恶心、呕吐、嗜睡、头痛、锥体外系反应）的发生率。结果3组患儿全部顺利完成手术，3组患儿年龄、体质量、手术时间、七氟醚吸入浓度比较差异无统计学意义（P＞0．05）；D组患儿拔管时及拔管后5 min的MAP、HR均显著低于N组、F组（P＜0．05），而D组、F组拔管时、拔管后5 min的MAP、HR比较差异均无统计学意义（P＞0．05）；3组患儿术毕至拔管时间比较差异无统计学意义（P＞0．05）；D组患儿苏醒期Riker镇静躁动评分及拔管后30 min FLACC评分明显低于N组、F组（P＜0．01）；3组患儿拔管后30 min均未见呼吸、循环抑制、恶心、呕吐、嗜睡、头痛、锥体外系反应等明显的不良反应。结论地佐辛用于小儿全身麻醉唇腭裂修复术围拔管期镇痛，安全有效。
목적：관찰지좌신용우소인전신마취하진악렬수복술위발관기적진통효과급안전성。방법선택우2013년1월1일지8월1일，재호북의약학원부속태화의원마취과전신마취하택기행진악렬수복술환인60례，미국마취의사협회（ASA ）Ⅰ～Ⅱ급，분위 D、F、N조，매조20례。소유환인균실시기관내삽관전신마취，술필전15 min D조정맥주사지좌신0．10 mg/kg ；F조정맥주사분태니1．00μg/kg ；N조급여등제량생리염수。관찰병기록삽관전、발관시、발관후5 min적평균동맥압（MAP）、심솔（HR）；술필지발관시간；소성기Riker진정조동평분；발관후30 min인동행위량표동통정도（FIACC ）평분급발관후30 min내각충불량반응（호흡、순배억제、악심、구토、기수、두통、추체외계반응）적발생솔。결과3조환인전부순리완성수술，3조환인년령、체질량、수술시간、칠불미흡입농도비교차이무통계학의의（P＞0．05）；D조환인발관시급발관후5 min적MAP、HR균현저저우N조、F조（P＜0．05），이D조、F조발관시、발관후5 min적MAP、HR비교차이균무통계학의의（P＞0．05）；3조환인술필지발관시간비교차이무통계학의의（P＞0．05）；D조환인소성기Riker진정조동평분급발관후30 min FLACC평분명현저우N조、F조（P＜0．01）；3조환인발관후30 min균미견호흡、순배억제、악심、구토、기수、두통、추체외계반응등명현적불량반응。결론지좌신용우소인전신마취진악렬수복술위발관기진통，안전유효。
Objective To observe the analgesic effect and safety of dezocine used in the periextubation period in pediatric pa-tients undergoing cleft lip and palate repair surgery under general anesthesia .Methods 60 American Society of Anesthesiologists (ASA ) grade Ⅰ - Ⅱ pediatric patients undergoing elective cleft lip and palate repair surgery under under general anesthesia in the central anesthesia department from January 1 to August 1 ,2013 were selected and randomly divided into group D ,F and N ,20 cases in each group .All the cases were performed the endotracheal intubation general anesthesia .At 15 min before the end of operation , the group D was intravenously injected by dezocine 0 .10 mg/kg ,the group F by fentanyl 1 .00 μg/kg and the group N (control group) by the isodose normal saline .The mean arterial pressure(MAP) and heart rate(HR) in all groups were recorded before in-duction ,extubation and at 5 min after extubation respectively .The extubation time ,Riker sedation-agitation scores and face ,legs ,ac-tivity ,cry and consolability(FLACC) scores at 30 min after extubation ,occurrence rates of various complications within 30 min after extubation(breathing and circulation depression ,nausea and vomiting ,drowsiness ,headache and extrapyramidal reactions were ob-served and recorded .Results The three groups completed the operation successfully .There were no significantly differences in age , body weight ,operation time and sevoflurane inhalation concentration among the three groups (P>0 .05) .HR and MAP in extuba-tion and at 5 min after extubation in the group D were lower than those in the group N and F(P<0 .05) ,but HR and MAP in extu-bation and at 5 min after extubation had no statistically significant difference between the group D and F (P>0 .05) .There was no statistically significant difference in the extubation time among 3 groups(P>0 .05) .The Riker sedation-agitation scores and the FLACC scores at 30 min after extubation in the group D were significantly lower than those in the group N and F with statistically significant difference( P< 0 .01 ) .Adverse reaction such as respiratory inhibition ,nausea ,vomiting ,lethargy ,headache ,vertebral body reaction were not found in the 3 groups after 30 minutes .Conclusion Dezocine used in pediatric patients with cleft lip and pal-ate repair surgery is safe and effective .