地佐辛与瑞芬太尼用于腹腔镜结直肠癌根治手术镇静、镇痛效果比较

发布时间：2018-01-27 14:34

本文关键词： 地佐辛瑞芬太尼腹腔镜结直肠癌根治手术镇痛镇静　出处：《中国医院药学杂志》2017年13期 　论文类型：期刊论文

【摘要】：目的:比较地佐辛与瑞芬太尼用于腹腔镜结直肠癌根治手术的镇静、镇痛效果。方法:70例行腹腔镜结直肠癌根治术治疗的患者根据受试者筛选入组顺序随机分为2组,地佐辛组(n=35例)麻醉维持采用地佐辛(1~3μg·kg~(-1)·min~(-1)),瑞芬太尼组(n=35例)麻醉维持采用瑞芬太尼(0.1~0.3μg·kg~(-1)·min~(-1))。比较两组患者不同时间点平均动脉压(MAP)、心率(HR)及视觉模拟评分(VAS)、布氏舒适评分(BCS)和镇静/躁动评分(SAS)变化,比较两组患者苏醒时间、气管导管拔除时间、离开PACU时间及不良反应发生率。结果:两组手术开始即刻和术毕时的MAP、HR均明显低于麻醉时,且瑞芬太尼组下降较地佐辛组更为显著(P0.05);地佐辛组苏醒时间、气管导管拔除时间及离开PACU时间均明显长于瑞芬太尼组(P0.05);地佐辛组苏醒后不同时间点VAS及SAS评分均明显低于瑞芬太尼组(P0.05),而BCS评分明显高于瑞芬太尼组(P0.05);两组患者肝肾功能指标及不良反应发生率比较无显著差异性(P0.05)。结论:腹腔镜结直肠癌根治手术麻醉维持使用地佐辛镇痛效果明显优于瑞芬太尼,且血流动力学更为平稳。
[Abstract]:Objective: to compare the sedation of dizosin and remifentanil in laparoscopic radical resection of colorectal cancer. Methods: one hundred and seventy patients undergoing laparoscopic radical resection of colorectal cancer were randomly divided into two groups according to the order of selection. Dizoxin group (n = 35) was maintained with dizoxine 1 渭 g 路kg ~ (-1) 路min ~ (-1) 路min ~ (-1)). In remifentanil group (n = 35), anesthesia was maintained with remifentanil 0.1 渭 g 路kg -1) 路minitanil. The mean arterial pressure was compared between the two groups at different time points (P < 0.05). ). Heart rate and visual analogue score (VASA), BCSs (BCSs) and SASs (sedation / restlessness score) were compared between the two groups. The recovery time and tracheal catheter extubation time were compared between the two groups. Results: the PACU HR at the beginning of operation and at the end of operation in both groups was significantly lower than that at anesthesia. The decrease of remifentanil group was more significant than that of dizosin group. The recovery time, tracheal extubation time and the time of leaving PACU in dizosin group were significantly longer than those in remifentanil group (P 0.05). The scores of VAS and SAS at different time points in dizosin group were significantly lower than those in remifentanil group (P 0.05), and the BCS score was significantly higher than that in remifentanil group (P 0.05). There was no significant difference in liver and kidney function and incidence of adverse reactions between the two groups. Conclusion: the analgesic effect of dizosin in laparoscopic radical operation for colorectal cancer is better than remifentanil. And the hemodynamics is more stable.
【作者单位】：武汉市第一医院药剂科;武汉市第一医院麻醉科;
【分类号】：R735.34
【正文快照】： 腹腔镜结直肠癌根治术具有机体创伤程度轻、疗效显著、术后病情恢复速度快等多种优点,目前已成为多数结直肠癌患者首选的手术治疗措施[1],而手术治疗期间镇痛效果良好是确保手术操作顺利完成的关键所在。瑞芬太尼是一种广泛应用于麻醉维持的药物,具有镇痛效果良好,持续静脉输

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