天津医药

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地佐辛对声门手术患者术后苏醒及应激的影响

刘爱芬,吕国义   

  1. 天津医科大学第二医院麻醉科
  • 收稿日期:2011-09-01 修回日期:2012-06-26 出版日期:2012-10-15 发布日期:2012-10-15
  • 通讯作者: 刘爱芬

Effect of dezocine in induction period on stress response and recovery profiles for glottis operation

Ai-Feng LIU,Guo-Yi LV   

  • Received:2011-09-01 Revised:2012-06-26 Published:2012-10-15 Online:2012-10-15
  • Contact: Ai-Feng LIU

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摘要： 【摘要】目的：观察地佐新用于支撑喉镜声门手术对患者应激、血流动力学、术后苏醒的影响。方法：48例ASAI-II级支撑喉镜声门手术患者，随机分为对照（C）组和地佐新（D）组（n=24）。D组麻醉诱导时给予地佐新5mg（1ml），C组给予生理盐水1ml。记录两组麻醉期间不同时间点的平均动脉压（MAP）、心率（HR）、拔管时间（手术结束至拔除气管导管），拔管时躁动评分和镇静评分，测定麻醉前和拔管后即刻的血浆皮质醇浓度。结果：拔管后即刻，C、D两组血流动力学变化差异有统计学意义（P<0.05）；拔管时间、拔管后镇静评分两组差异无统计学意义（P>0.05）；D组拔管时躁动评分明显低于C组（P〈0.05）；拔管后即刻C组血浆皮质醇明显高于D组（P〈0.05）。结论：术前给予地佐新可减轻支撑喉镜声门手术病人围术期应激、不延长苏醒时间，降低拔管后躁动，提高苏醒质量。

关键词: 地佐新, 支撑喉镜, 应激反应, 躁动

Abstract: [Abstract]Objective To observe the influence of dezocine given intravenously in induction period on stress response, haemodynamics, recovery profiles for glottis operation by retaining laryngoscope. Methods 48 adult patients, ASA I-II, undergoing glottis operation under retaining laryngoscope，were randomly divided into group C and D(n=24). Group C received 1ml of saline; group D dezocine 5mg/1ml. Mean arterial blood pressure (MAP) and heart rate (HR) at different time during operation were recorded, the extubating time( duration from the end of operation to extubation), agitation score at extubation and the Ramsay score of sedation after 5 min of extubation also recorded. Blood sample was drawn pre-anesthsia and at the end of operation, the value of cortisol in the plasma was determined. Results：MAP in group D was a little lower than that of group C(P<0.05), HR a little higher than that of group C(P<0.05) at 5 min later extubation; There was no significant differences in both extubating time and the Ramsay score of sedation at 5 min later extubation between two groups (P>0.05). Agitation score in group D was much lower than that of group C during extubation（P<0.05）.The increasing value of cortisol in group D was a little lower than that of groupC (P<0.05). Conclusion 5mg of dizocine at pre-operation intravenously may decrease patient’s stress response peri-operatively, agitation after extubation, and no prolong the recovery time, also improve the recovery qualities, who undergoes glottis surgery by retaining laryngoscope.

Key words: dezocine, retaining laryngoscope, stress response, agitation