摘要
目的比较在腹腔镜胆囊切除术中追加地佐辛或芬太尼的麻醉效果、不良反应、麻醉苏醒及对术后镇痛的影响。方法选择ASA(美国麻醉医师协会)分级Ⅰ～Ⅱ级拟行腹腔镜胆囊切除术的患者60例,随机分成二组,Ⅰ组:追加地佐辛组,Ⅱ组:追加芬太尼组;分别记录诱导前、切皮时、气腹后5min、气腹取消后,手术结束时的心率(HR)、平均动脉血压(MAP)、血氧饱和度(SpO2);术毕记录手术至术毕睁眼时间、术毕至拔管时间、恶心呕吐及疼痛等不良反应。结果二组患者的心率、平均动脉血压在切皮时、气腹后5min及气腹取消后、手术结束时有一定增加,但差异无统计学意义(P>0.05);二组患者手术至术毕睁眼时间、术毕至拔管时间比较差异无统计学意义(P>0.05);Ⅰ组术后恶心呕吐发生率更低(P<0.05);Ⅰ组术后30min、2h、4h镇痛效果优于Ⅱ组(P<0.05)。结论地佐辛用于腹腔镜胆囊切除术具有血流动力学影响小、术后镇痛更持久的优点,适合短小手术并拒绝术后镇痛患者。
Objective To compare the clinical afficy results of Dezocine or Fentanyl at anesthetic effect, adverse reactions, anesthesia palinesthesia and postoperative analgesia in laparoseopic cholecystectomy. Methods Line laparoscopic cholecystectomy in 60 cases,ASA Ⅰ-Ⅱ ,were randomly divided into two groups.. group Dezocine（ Ⅰ group,n = 30） and group Fentanyl（ Ⅱ group,n = 30）. HR, MAP and SpO2 were observed and recorded before induction,skin incision , 5 mins after pneumoperitoneum, and ending pneumoperitoneurn. Then the time from operation initiation to eye opening after operation, the time from operation termi- nation to extubation, and adverse effects（nausea, vomiting and pain） were observed and recorded at the end of operation. Results HR, MAP of all subjects were increased partly when skin incision, 5 mins after pneumoperitoneum, ending pneumoperitoneum and ending operation, but the difference in two groups was no significant. The time from operation initiation to eye opening after operation and time from operation termination to extubation in two groups were no significant difference too. Incidence of nausea and vomiting in group I was less than group Ⅱ （P〈0.05）, and analgesia effects of 0.5,2 and 4 hours after operation in group Ⅰ was better too（P〈0.05）. Conclusion In laparoscopic cholecystectomy, Dezocine may be suitable for minor surgery cases who refused postoperative analgesia with little hemodynamic effects to patients, delay postoperative analgesia.
出处
《中国煤炭工业医学杂志》
2013年第5期700-701,共2页
Chinese Journal of Coal Industry Medicine
