地佐辛联合丙泊酚预防腹腔镜胆囊切除术患者全麻苏醒期躁动的效果

摘要

Objective To discuss curative effect of Dezocine combined with Propofol on agitation of patients treated with laparoscopic cholecystectomy (LC) during the recovery period of general anesthesia. Methods 70 cases of patients treated with LC in the First People's Hospital of Yongkang City, from January 2012 to December 2013, were selected and divided into observation group (35 cases) and control group (35 cases). The patients in two groups were given rou-tine LC under the general anesthesia with trachea cannula, and all the anesthesia drugs were stopped 10 minutes before the complement of operation. The patients in observation group were additionally given 0.1 mg/kg Dezocine and 10 g/(kg·min) Propofol, while the patients in control group were additionally given 0.1 mg/kg Dezocine untile the completion of the operation. The revival time, pain, agitation during the recovery period and ramsay scores of patients in two groups were observed and compared. Results After comparing the spontaneous breathing recovery time, eyes open (EO) time and extubation time of patients in two groups, the differences were not statistically significant (P>0.05). The VAS and RS scores of patients in observation group at T1, T2 and T3 [(2.1±0.4), (2.3±0.5), (2.7±0.7); (0.7±0.2), (0.6±0.2), (0.7±0.2) scores] were all lower than those in control group [(4.0±1.0), (3.7±0.9), (3.2±0.8); (1.7±0.4), (1.9±0.5), (1.8±0.4) scores], the differences were statistically significant (t = 3.34, 2.87, 2.23, 3.73, 5.29, 4.17, P<0.05 or P< 0.01). Compared the RSS scores of patients in two groups, the difference was not statistically significant (P>0.05). Conclu-sion Dezocine combined with Propofol can obviously lighten the pain degree of patients treated with LC and effectively prevent and release the agitation during the recovery period after general anesthesia, which will not influence the EO time of patients after anesthesia or the ramsay degree, and it is a safe and effective therapy to prevent the agitation dur-ing the recovery period after general anesthesia.%目的：探讨地佐辛联合丙泊酚预防腹腔镜胆囊切除术患者全麻苏醒期躁动的效果观察。方法选取2012年1月～2013年12月在浙江省永康市第一人民医院择期行腹腔镜胆囊切除术患者70例，分为观察组和对照组，每组各35例。两组患者均在气管插管全身麻醉下行常规腹腔镜胆囊切除术，术毕前10 min停所有麻醉用药，观察组患者加用地佐辛0.1 mg/kg及丙泊酚10 g/(kg·min)，对照组患者加用地佐辛0.1 mg/kg维持至术毕。观察并比较两组患者麻醉后的苏醒时间、疼痛、苏醒期躁动和镇静评分情况。结果两组患者的自主呼吸恢复时间、睁眼时间和拔管时间比较，差异无统计学意义(P>0.05)。观察组患者拔管时(T1)、拔管后5 min(T2)及拔管后30 min(T3)3个时点视觉模拟评分和苏醒期躁动评分[(2.1依0.4)、(2.3依0.5)、(2.7依0.7)、(0.7依0.2)、(0.6依0.2)、(0.7依0.2)分]均少于对照组[(4.0依1.0)、(3.7依0.9)、(3.2依0.8)、(1.7依0.4)、(1.9依0.5)、(1.8依0.4)分]，差异均有统计学意义(t =3.34、2.87、2.23、3.73、5.29、4.17，P<0.05或P<0.01)，两组患者的镇静评分比较，差异无统计学意义(P>0.05)。结论地佐辛联合丙泊酚可明显减轻腹腔镜胆囊切除术患者疼痛程度，有效预防和减少患者全麻苏醒期躁动的发生，且不影响患者麻醉后苏醒时间，不加重患者镇静程度，是预防全麻术后苏醒期躁动一种安全有效的方法。