CAJ | 학술논문

[目的]探讨地佐辛对腹腔镜手术(laparoscopic surgery,LS)超前镇痛的有效性及安全性.[方法]选择96例择期行LS患者,术前按美国麻醉医师协会(A S A)分级评估为I~I I级,手术耐受力良好,麻醉经过平稳,随机均分为三组,均采用静脉复合麻醉,术中靶控输注异丙酚和瑞芬太尼,间断给予顺式阿曲库铵维持肌松.麻醉成功诱导后,实验A组静脉注射地佐辛0.2mg·kg-1,对照B组静脉注射芬太尼4.0μg·kg-1,以及安慰剂C组静脉注射生理盐水2.0mL.观察记录三组患者术中各时点熵指数(SE、RE)的监测结果,同时记录各组患者睁眼时间、术后疼痛视觉模拟评分(VAS)、拔管时间、呼吸恢复时间,并且统计各组患者术后烦躁不安、恶心呕吐、呼吸抑制等不良反应发生率.[结果]术中实验A、对照B组患者在手术操作的应激下熵指数值波动明显<安慰剂C组,有统计学意义(P<0.05);呼吸恢复时间、睁眼时间、拔管时间均明显<安慰剂C组,有统计学意义(P<0.05);在术后VAS评分方面,实验A组比对照B、安慰剂C组明显低,有统计学意义(P<0.05);术后烦躁不安方面,实验A组患者发生率明显<对照B、安慰剂C组,有统计学意义(P<0.05);实验A、安慰剂C组术后恶心呕吐发生率明显<对照B组,有统计学意义(P<0.05).[结论]地佐辛超前镇痛可明显缓解LS患者的早期疼痛,能有效减轻停药后的痛觉过敏,且不良反应发生率低,安全性、舒适度高,是一种较理想的LS超前镇痛药物.
[목적]탐토지좌신대복강경수술(laparoscopic surgery,LS)초전진통적유효성급안전성.[방법]선택96례택기행LS환자,술전안미국마취의사협회(A S A)분급평고위I~I I급,수술내수력량호,마취경과평은,수궤균분위삼조,균채용정맥복합마취,술중파공수주이병분화서분태니,간단급여순식아곡고안유지기송.마취성공유도후,실험A조정맥주사지좌신0.2mg·kg-1,대조B조정맥주사분태니4.0μg·kg-1,이급안위제C조정맥주사생리염수2.0mL.관찰기록삼조환자술중각시점적지수(SE、RE)적감측결과,동시기록각조환자정안시간、술후동통시각모의평분(VAS)、발관시간、호흡회복시간,병차통계각조환자술후번조불안、악심구토、호흡억제등불량반응발생솔.[결과]술중실험A、대조B조환자재수술조작적응격하적지수치파동명현<안위제C조,유통계학의의(P<0.05);호흡회복시간、정안시간、발관시간균명현<안위제C조,유통계학의의(P<0.05);재술후VAS평분방면,실험A조비대조B、안위제C조명현저,유통계학의의(P<0.05);술후번조불안방면,실험A조환자발생솔명현<대조B、안위제C조,유통계학의의(P<0.05);실험A、안위제C조술후악심구토발생솔명현<대조B조,유통계학의의(P<0.05).[결론]지좌신초전진통가명현완해LS환자적조기동통,능유효감경정약후적통각과민,차불량반응발생솔저,안전성、서괄도고,시일충교이상적LS초전진통약물.
@@@@Abstact:[Objective] To evaluate the preemptive analgesic efficacy and safety of dezocine injection in patients undergoing laparoscopic surgery. [Methods]96 patients undergoing elective laparoscopic surgery, were randomly divided into three groups, used intravenous anesthesia with endotracheal intubation, intraoperative target control ed infusion of propofol and remifentanil, intermittent given cis-atracurium to maintain muscle relaxants, 5min after induction of anesthesia; group A vein injection of dezocine 0.2mg/kg, the group B intravenous injection of fentanyl 4ug/kg, group C received intravenous injection of saline 2 ml. Observe and record the monitoring results of the three groups of patients at each time point entropy indexes(SE, RE), record at the same time the recovery time from each group of patients with respiratory, eye opening time, extubation time and postoperative pain visual analogue score(VAS), and nake statistics of each group of patients with irritability, nausea, vomiting, respiratory depression, the incidence of adverse reactions. [Results] Group A and group B patients in the surgical operation under stress, the entropy index value fluctuations significantly were less than the group C, breathing recovery time, eye opening time, extubation time were significantly shorter than group C;the group A patients postoperative VAS score was significantly lower than group B and group C; group A of patients with postoperative irritability incidence was significantly lower than group B and group C; the incidence of postoperative nausea and vomiting of group A and group C was significantly lower than group B. [Conclusion] Dezocine injection preemptive analgesia can significantly al eviate the pain of laparoscopic surgery in patients early, can effectively reduce hyperalgesia after stopping, with a low incidence of adverse reactions, with safety and comfort, it is an ideal preemptive analgesia drug for undergoing laparoscopic surgery.