摘要
目的：探讨地佐辛与芬太尼预防阑尾切除术牵拉反应的疗效及安全性。方法：90例硬膜外阻滞下行阑尾切除术的患者随机分为地佐辛组和芬太尼组,均采用常规硬膜外阻滞麻醉,地佐辛组切皮前静注地佐辛0.1mg·kg-1,微泵维持至术毕,维持剂量1.5～2μg·kg-1·min-1,芬太尼组切皮前静注芬太尼1μg·kg-1,微泵维持至手术结束,维持剂量0.2～0.3μg·kg-1·min-1。观察并比较手术前（T0）、切皮时（T1）、牵拉阑尾时（T2）及手术结束时（T3）两组患者生命体征（SBP、DBP、HR、Sp O2）的变化。同时观察两组患者手术时牵拉反应及术后不良反应发生情况。结果：地佐辛组T1、T2、T3时HR、SBP、DBP、Sp O2与T0时比较无明显变化（P〉0.05）。芬太尼组T1、T2、T3时HR、SBP、DBP较T0时明显升高（P〈0.05或P〈0.01）,而Sp O2明显降低（P〈0.05或P〈0.01）。芬太尼组T1、T2、T3时HR、SBP、DBP均较地佐辛组升高（P〈0.05或P〈0.01）,而Sp O2较地佐辛组降低（P〈0.05或P〈0.01）。地佐辛组术中牵拉反应发生率及不良反应发生率均低于芬太尼组（P〈0.05）。结论：硬膜外阻滞下阑尾切除术术中辅助使用地佐辛能取得较芬太尼更佳的疗效,患者生命体征稳定,牵拉反应和不良反应少,是一种安全有效的麻醉方式。
Objective： To discuss curative effect and security comparison of dezocine and fentanyl to prevent stretch reaction in appendectomy. Methods： 90 cases of patients with appendectomy under epidural block were divided into dezocine group and fentanyl group at random. The patients in two groups were given routine epidural anesthesia,and the patients in dezocine group were given dezocine 0. 1 mg·kg- 1by intravenous injection before skinincision,which last until the end of operation with the dose of 1. 5-2μg·kg- 1·min- 1by minipump,while the patients in fentanyl group were given fentanyl 1 μg·kg- 1by intravenous injection before skinincision,,which last until the end of operation with the dose of0. 2-0. 3 μg·kg- 1·min- 1by minipump. The changes of vital signs（ SBP,DBP,HR,Sp O2） of patients in two groups before the operation（ T0）,at skinincision time（ T1）,pulling the appendix（ T2） and the end of operation（ T3） were observed and compared. Meanwhile,the stretch reaction and postoperative untoward effect of patients in two groups during the operation were observed. Results： Compared with T0,the HR,SBP,DBP and Sp O2 of patients in dezocine group at T1,T2 and T3showed no obvious change（ P〈0. 05）,while the HR,SBP and DBP of patients in fentanyl group at T1,T2 and T3obviously rose（ P〈0. 05 or P〈0. 01）,and Sp O2 obviously declined（ P〈0. 05 or P〈0. 01）. Compared with dezocine,HR,SBP and DBP of patients in fentanyl group at T1,T2 and T3obviously rose（ P〈0. 05 or P〈0. 01）,while Sp O2 declined（ P〈0. 05 or P〈0. 01）. The intraoperative stretch reaction and untoward effect occurrence rates of patients in dezocine group were much lower than those in fentanyl group（ P〈0. 05）. Conclusion： Compared with fentanyl,the application of dezocine in the appendectomy under epidural block as adjunctive therapy can achieve more favorable curative effect,with more stable vital signs of patients and less occurrence rates of stretch reaction and postoperative untoward effect,which is a safe and effective anesthesia method.
出处
《药物流行病学杂志》
CAS
2015年第4期197-199,共3页
Chinese Journal of Pharmacoepidemiology
