地佐辛预防瑞芬太尼复合全麻苏醒期痛觉过敏作用的临床观察

摘要

目的：观察地佐辛是否有预防瑞芬太尼复合全麻苏醒期疼痛过敏的作用。方法选取择期行腹腔镜下胆囊切除手术（LC）患者60例，美国麻醉医师协会（ASA）分级Ⅰ～Ⅱ级，按数字表法随机分为对照组30例、观察组30例。对照组在瑞芬太尼停药前后不给任何镇痛药物，观察组在瑞芬太尼停药前15 min静脉注射地佐辛10 mg。记录两组患者苏醒即刻（T1）、苏醒后（T2）HR、MAP及苏醒时间，并采用Prince-henry疼痛评分法对患者进行手术后疼痛评分。结果两组患者苏醒时间差异无统计学意义（P＞0.05）。观察组HR、MAP在T1、T2时间点均无明显变化（P均＞0.05），对照组HR、MAP在T2时间点明显高于T1（P＜0.05），观察组H R、MAP 在 T2时间点均明显低于对照组（P 均＜0.05），观察组手术后疼痛评分明显低于对照组（ P ＜0.01）。结论地佐辛可以预防瑞芬太尼复合全麻苏醒期疼痛过敏，减少瑞芬太尼复合全麻苏醒期不良反应。%Objective To observe the effects of dezocine whether in preventing hyperalgesic action during recovery period of remifentanil composite general anesthesia. Methods According to the digital table,60 patients underwent laparoscopic cholecystectomy operation (LC),which American anesthesiologists (ASA) grade inⅠtoⅡ,were randomly divided into the control group and the observation group,each group 30 cases.Before and after drug discontinuation in remifentanil,the control group was not given any analgesic drug,while before 15 minute of drug discontinuation in remifentanil the observation group was given intravenous dezocine 10 mg.The HR, MAP at immediately(T1), wake up wake(T2) and recovery time of the two groups were recorded,and using the Prince-henry pain score method for patients after operation pain score. Results The two groups had no statistically significant difference between the patients recovery time (P>0.05).The observation group HR,MAP in T1,T2 time point showed no significant change (P>0.05),control group HR,MAP at T2 time point was significantly higher than that of T1 (P<0.05),were observed in group HR,MAP in T2 time points were significantly lower than that of control group(all P < 0.05),see table 1.To observe the pain score of group after operation was significantly lower than the control group (P<0.01). Conclusion Dezocine can prevent preventing hyperalgesic action during recovery period of remifentanil composite general anesthesia,and reduce the adverse reaction of remifentanil anesthesia recovery period.