地佐辛用于瑞芬太尼麻醉腹腔镜胆囊切除手术后镇痛的临床观察.doc

地佐辛用于瑞芬太尼麻醉腹腔镜胆囊切除手术后镇痛的临床观察 ? 126? 实用临床医药鸯志2011年第15卷第9期JournalofClinicalMedicineinPractice…一.………. 地佐辛用于瑞芬太尼麻醉腹腔镜胆囊切除 手术后镇痛的临床观察 米志华,魏桂良,张忠 (湖南省岳阳市第一人民医院麻醉科,湖南岳阳,414000) 摘要:目的观察地佐辛在防治瑞芬太尼麻醉腹腔镜下胆囊切除手术后疼痛的有效性.方法40例择期行腹腔镜胆 囊切除手术患者,ASAI～Ⅱ级,年龄20--60岁,随机分为两组,地佐辛组和芬太尼组.地佐辛组和芬太尼组患者分别于手术 结束前10rain给予地佐辛0.1mgamp;g和芬太尼1t~g/kg.记录术前,拔管时,拔管后30min,1h,2h的平均动脉压(MAP),心 率(HR)和脉搏氧饱和度(sp()2).记录拔管时间和拔管时,拔管后30min,1h,2h时的镇静评分(r~qlsaysedationscore,RSS)和 疼痛视觉模拟评分(visualanaloguescale,VAS),记录因疼痛需要增加使用芬太尼的患者数及其增用剂量.观察术后不良反应 的发生情况.结果地佐辛组患者在拔管时,拔管后30min,1h和2h各时间点的MAP比芬太尼组低,差异有统计学意义(P lt;0.05);两组患者各时间点心率,拔管时间和不良反应的发生率差异无统计学意义(Pgt;0.05).地佐辛组患者在拔管后30 min,1h和2h各时间点的VAS比芬太尼组低,差异有统计学意义(Plt;0.05),两组各时间点RSS差异无统计学意义(Pgt;0. 05).结论地佐辛0.1mg/kg能够安全有效地用于瑞芬太尼麻醉腹腔镜胆囊切除术后的镇痛. 关键词:地佐辛;瑞芬太尼;腹腔镜;镇痛 中图分类号:R657.4文献标志码:A文章编号:1672—2353(2011)09—0126—03 Observationofdizocine eholeeystectomywith analgesiaafterlaparoseopie remifentanilanaesthesia MIZhi—hua,WEIGui (YueyangPeopleSHospital, 一 liang,ZHANGZhong Yueyang,Hunan,414000) ABSTRACT:ObjectiveToobservetheanalgesicactivitiesofDizocineafterlaparoscopic cholecystectomywithRemifentanilanaesthesia.MethodsFortycasesofcholecystectomypatients underlaparoscopy(ASAI～1I,20--60years)wereselectedanddividedintotwogroups(咒=20) randomly;Dizocinegroup(GroupD):Dizocine0.1mg/kgwasaddedbyintravenousinjection 10minbeforetheendofoperation;Fentanygroup(GroupF):Fentany0.001mg/kgwasaddedat theSalTletime.Thetimeofextubation,theRamsaysedationscore(RSS),visuaIanaloguescale (VAS)atthemomentofextubationwererecorded30min.1hand2hafterextubation.Thead— versereactionswereobserved.ResultsTheMAPingroupDatthemomentand30min,1h,2h afterextubationwerelowerthanthatingroupF(尸lt;0.05);HR,extubationtimeandadversere— actionswerenotdifferentbetweengroupDandgroupF(Pgt;0.05).VASatthetimeof30min,1 hand2hingroupDwerelowerthanthatingroupF(Plt;0.05),andtherewasnodifference aboutRSSbetweengroupDandF(Pgt;0.05).ConclusionDizocine0.1mg/kgcanbeusedfor analgesiaafterlaparoscopiccholecystectomywithRemifentani1anaesthesiaanditiss