地佐辛对气管拔管期气道反应及心血管反应的影响

目的 研究全身麻醉术毕前应用镇痛药地佐辛对气管拔管期心血管反应、呛咳程度、镇静程度的影响,探讨其在麻醉苏醒期应用的可行性及安全性.方法 选择择期需要全身麻醉,ASAⅠ～Ⅱ级的肿瘤手术患者60例.根据手术结束前30 min用药方案的不同随机分为两组,对照组(Control,C组)和地佐辛组(Dezocine,D组),每组30例.两组患者的麻醉诱导及维持用药方案相同.以静脉注射芬太尼及丙泊酚、维库溴铵,进行麻醉诱导,麻醉维持以丙泊酚靶控,异氟醚吸入,间断给予维库溴铵维持.手术结束前30 min,分别静脉给予单次剂量的地佐辛0.125 mg/kg或等容积的生理盐水.术毕当达到拔管指征时,拔除气管导管.分别记录两组患者气管拔管期各观察点平均动脉压(MAP)、心率(HR)、呼吸频率(RR)的变化,呛咳发生率和严重程度;并记录镇静评分,麻醉苏醒时间,拔管时间及并发症.结果 MAP、HR值在拔管时及拔管后2 min在C组显著增高,与D组比较差异有统计学意义(P<0.05).呛咳严重程度及发生率D组明显减少,两组比较差异有统计学意义(P<0.05).镇静评分及导管拔除时间,两组比较差异无统计学意义(P﹥0.05).结论 手术结束前30 min静脉注射地佐辛0.125 mg/kg,能有效减轻拔管期的心血管反应和气道反应,对术后呼吸运动无影响,且不影响患者苏醒.

Effect of decozine on airway and cardiovascular response to extubation

Objective To evaluate the effect of dezocine on airway and cardiovascular response to emergence from tracheal extubation.Methods Sixty cases of ASAⅠ-Ⅱ,undergoing radical surgery,on schedule were randomly divided into two groups,dezocine group and saline group.All patients received a standard general anaesthetic comprising propofol,vecuronium and isoflurane.30 min before the end of surgery,a bolus dose of decozine 0.125 mg/kg or an equivalent volume of saline placebo was given.Tracheal extubation was performed when stardard criteria were achieved.MAP and HR,RR were recorded during and after extubation.Incidence and severity of coughing and OAA/S score were recorded.Time to extubation and adverse effect was recorded.Results MAP and HR were obviously increased in saline group at extubation and 2 min after extubation compared with the baseline values,there were significant differences between the two groups(P<0.05).Incidence and severity of coughing were significantly reduced in dezocine group,there were significant differences between the two groups(P<0.05).There were not significant difference in OAA/S score and time to extubation.Conclusion A bolus dose of decozine 0.125 mg/kg 30 min before operation attenuated cardiovascular responses and airway reflexes during extubation.There were no adverse effects at extubation.Time to recovery from anaesthesia are not significantly prolonged.