摘要
目的：比较地佐辛、氟比洛芬酯超前镇痛对食管癌患者围术期应激反应的影响,探讨地佐辛超前镇痛用于临床麻醉的可行性及效果。方法：全麻下行食管癌根治术患者60例,ASAⅠ~Ⅱ级,随机分为地佐辛组和氟比洛芬酯组,每组30例。分别比较两组在给药前即刻（T0）、气管插管后2 min（T1）、切皮后30 min（T2）、拔除气管导管后2 min（T3）及术后1 h（T4）血清皮质醇和血糖浓度及拔管即刻、拔管后0.5、1 h两组VAS和Ramsay评分。结果：组内比较：与T0比较,D组血清皮质醇和血糖浓度在T2、T3时点升高（P〈0.05）,F组在T1~T3时点升高（P〈0.05）。组间比较：与D组比较,F组血清皮质醇和血糖浓度在T1、T2时点升高（P〈0.05）,在T0、T3、T4时点差异无统计学意义;Ramsay评分在拔管即刻和拔管后0.5 h升高（P〈0.05）。VAS评分两组比较差异无统计学意义。结论：地佐辛可用于围术期超前镇痛,且效果确切,比氟比洛芬酯能更好的抑制围术期应激反应,并提供良好的镇静水平。
Objective： Compared with the effect of preemptive analgesia on stress response between Dezocine and Flurbiprofen was used in patients of esophageal cancer during the perioperative period,investigated the feasibility and effect on preemptive analgesia of Dezocine was used in clinical anesthesia.Methods： 60 patients of esophageal cancer surgery under global anesthesia,ASA Ⅰ-Ⅱ level,were randomly divided into group of Dezocine and group of Flurbiprofen（n=30）.Compared with the serum cortisol and blood glucose levels of two groups in preanesthetic medication（T0）,2 min of after endotracheal intubation（T1）,30 min of after skin incision（T2）,2 min after extubation（T3） and 1h after extubation（T4）.Compared with the score of VAS and Ramsay in extubation,0.5 h after extubation,1 h after extubation.Results： Comparison of within groups： Compared with the concentrations of serum cortisol and glucose at T0,group D was significantly increased（P0.05） at the point of T2,T3,group F was significantly increased（P0.05） at the point of T1-T3.Comparison of inter-groups： compared with the concentrations of serum cortisol and glucose of group D,the group F was significantly increased（P0.05） at the point of T1,T2,there was no significant difference at the point of T0,T3,T4.The score of Ramsay was significantly increased（P0.05） in extubation and 0.5 h after extubation.Comparison of the score of VAS was no significant difference by two groups.Conclusion： Dezocine can used as preemptive analgesia in the perioperative period,and the effect was exact,was better than Flurbiprofen on inhibitting the stress response during perioperative period,and provided better level of sedation.
出处
《南通大学学报（医学版）》
2012年第6期476-478,共3页
Journal of Nantong University(Medical sciences)
关键词
食管癌
地佐辛
氟比洛芬酯
超前镇痛
应激反应
esophageal cancer
Dezocine
Flurbiprofen
preemptive analgesia
stress response
