地佐辛预防和治疗腹部手术患者苏醒期躁动的观察

目的探讨地佐辛在预防和治疗全麻患者苏醒期躁动的有效性及安全性。方法 ASAⅠ～Ⅱ级的择期腹部手术120例,随机双盲分为三组,每组40例,即地佐辛组、芬太尼组和对照组。在缝合皮肤前静脉注射拟观察的药物,观察患者在拔管即刻和在术后恢复室的躁动及镇静评分、药物不良反应、拔管时间及缓解情况等,对照组患者若发生躁动则静脉注射地佐辛0.1 mg/kg。结果 三组患者在拔管时间及苏醒时间差异无统计学意义,对照组拔管后躁动的发生率明显高于芬太尼组及地佐辛组,差异有统计学意义(P<0.01)。地佐辛组的镇静评分较高,但没有过度镇静或苏醒延迟的发生,各组间比较差异有统计学意义(P<0.05)。在术后恢复室芬太尼组追加芬太尼后躁动缓解率为43.8%(7/16),而地佐辛组追加地佐辛后躁动缓解率为100.0%(6/6)。对照组发生躁动的患者经静脉注射地佐辛后躁动缓解或减轻率为76.0%(19/25),芬太尼组7例追加芬太尼后有3例出现一过性的呼吸抑制,而地佐辛组及对照组均无呼吸抑制的发生。结论地佐辛是预防和治疗腹部手术患者全麻苏醒期躁动的理想药物,优于芬太尼。

The observation of dezocine on prevention and treatment of emergence agitation after abdomen surgery

Objective To investigate the efficacy and safety of dezocine on prevention of emergence agitation in adult patients during recovery period after abdomen surgery.Methods 120 ASAⅠ-Ⅱ patients scheduled for elective abdomen surgery under general anesthesia were randomly divided into three groups： group D with dezocine,group F with fentanyl and group N with saline.Dezocine 0.1 mg /kg,fentanyl 1 μg/kg and 1 ml saline were administered intravenous respectively just before the beginning of skin suturing.The incidence of emergence agitation,restlessness and sedation scale,extubate and recovery time,emergence agitation anesis,and adverse events were evaluated.Results No significant statistic differences have been showed in extubate and recovery time between group D,group F and Group N（P0.01）.The incidence of emergence agitation was significantly higher in group N than that in group F and group D（P0.01）.The sedation scale was higher in group D without excess sedation and palinesthesia delayed.When another bolus was administered intravenous,the emergence agitation remitted significantly in group D 6/6（100.0%） and group N 19/25（76%） than in group F 7/16（43.8%）,but respiratory depression was very common in group F.Conclusion Benefit from the analgesic and sedative property of dezocine,it could be one of the ideal drugs to prevent and relieve emergence agitation in the patients after abdomen surgery with less frequent adverse events.Fentanyl can not prevent and relieve emergence agitation effectively.