地佐辛联合罗哌卡因局部麻醉预处理对腹腔镜下胆囊切除术男性患者苏醒期躁动的影响

发布时间：2018-06-08 01:27

本文选题：苏醒期躁动 + 地佐辛　；参考：《中国医药导报》2016年07期

【摘要】：目的探讨地佐辛联合罗哌卡因局部麻醉预处理对腹腔镜下胆囊切除术(LC)男性患者苏醒期躁动的影响。方法选择2014年1~12月于江山市人民医院择期行LC的男性患者60例,随机分为治疗组和对照组,每组各30例。两组麻醉诱导及维持方法相同,治疗组在手术结束前20 min静脉注射地佐辛0.1 mg/kg,手术结束后0.75%盐酸罗哌卡因行切口局部浸润麻醉,对照组不予处理。术后转入麻醉恢复室。观察两组术后苏醒时间、拔管时间;记录术后苏醒期躁动发生率和程度;记录麻醉前(T_0)、拔管前(T_1)、拔管后5 min(T_2)、拔管后10 min(T_3)、拔管后30 min(T_4)、拔管后1 h(T_5)的收缩压(SBP)、舒张压(DBP)、心率(HR)、血氧饱和度(Sp O2);在拔管后30 min、1 h、4 h、12 h各时间点对患者进行视觉模拟评分(VAS);并观察患者导尿管不适程度及恶心呕吐等不良反应。结果与T_0比较,对照组在T_1、T_2、T_3、T_4、T_5时SBP、DBP、HR均升高(P0.05);治疗组在T_1、T_2、T_3、T_4、T_5各时点的SBP、DBP、HR均低于对照组(P0.05);治疗组清醒后导尿管无不适(0级)患者21例(70%),多于对照组的3例(10%)(P0.01);治疗组在拔管后30 min、1 h、4 h VAS评分低于同时间点的对照组(P0.05或P0.01);治疗组安静无烦躁(0级)患者23例(76.67%),多于对照组的5例(16.67%)(P0.01)。结论地佐辛联合罗哌卡因局部浸润麻醉预处理能有效预防LC男性患者苏醒期躁动,提高患者的舒适度,不延长苏醒时间。
[Abstract]:Objective to investigate the effect of dizosin combined with ropivacaine local anaesthesia preconditioning on restlessness in patients with LC during laparoscopic cholecystectomy. Methods A total of 60 male patients with LC from January to December 2014 in Jiangshan people's Hospital were randomly divided into treatment group (n = 30) and control group (n = 30). The anesthesia induction and maintenance were the same in the two groups. In the treatment group, dizosin 0.1 mg / kg was injected intravenously 20 min before the end of operation, and 0.75% ropivacaine hydrochloride was used in the incision local infiltration anesthesia after the operation, but not in the control group. After operation, it was transferred to the anesthesia recovery room. The postoperative recovery time and extubation time were observed, and the incidence and degree of restlessness in postoperative recovery period were recorded. The systolic pressure (SBP), diastolic pressure (DBP), heart rate (HR), HRT (HRT), blood oxygen saturation (SPA) were recorded before anesthesia, before extubation, 5 min after extubation, 10 min after extubation, 30 min after extubation, 1 h after extubation and 12 h after extubation. The adverse reactions such as urinary catheter discomfort and nausea and vomiting were observed. The results were compared with T _ 0, In the control group, the number of SBPDBPHR increased at T _ 1 / T _ 3 / T _ T _ 5; in the treatment group, it was lower than that in the control group at T _ 1T _ 2 / T _ 3T _ 4 / T _ 5; in the treatment group, it was lower than that in the control group (P _ 0.05); in the treatment group, it was more than in the control group (P _ 0.01); in the treatment group, 30 min after extubation, the VAS was assessed at 1 min for 4 h. The scores were lower than those of the control group (P0.05 or P0.01g), the patients in the treatment group were quiet without irritability grade 0 (23 cases), and more than 5 cases in the control group (P 0.01). Conclusion Dizocin combined with ropivacaine local infiltration anesthesia preconditioning can effectively prevent restlessness and increase the comfort of LC male patients without prolonging the recovery time.
【作者单位】：浙江省江山市人民医院麻醉科;
【基金】：浙江省衢州市科技局指导性科技计划项目(2015116)
【分类号】：R614

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