不同剂量地佐辛超前镇痛对妇科腹腔镜手术患者术后苏醒期质量的影响

发布时间：2018-08-07 06:56

【摘要】：目的：探讨不同剂量地佐辛超前镇痛对全麻妇科腹腔镜手术患者术后苏醒期质量的影响。方法：选择择期全身麻醉下行妇科腹腔镜手术患者120例,随机分为4组(n=30)：D1组(地佐辛0.1mg/kg),D2组(地佐辛0.2mg/kg), D3组(地佐辛0.3mg/kg)和对照组C组(生理盐水2m1)。麻醉诱导前5min, D1、 D2、D3组和C组分别静脉静推地佐辛0.1mg/kg、0.2mg/kg、0.3mg/kg和生理盐水2m1。然后以丙泊酚、瑞芬太尼及罗库溴铵进行麻醉诱导和术前麻醉维持,记录四组患者手术时间,入PACU时(T0)、拔管前(T1)、拔管后lmin (T2)、拔管后5min(T3)和拔管后10min(T4)的SBP、DBP、MBP、HR、 SpO2、R、VAS评分和清醒时间、拔管时间、镇静评分、呛咳评分、躁动评分及其他不良反应。结果：D2、D3组的SBP、HR明显低于C组和D1组,且更平稳；而D3组的SpO2、R明显低于其余三组,易产生呼吸抑制。VAS评分：D2、D3组的VAS评分优于C组和D1组,术后镇痛效果更满意。但D3组的术后清醒时间和拔管时间明显长于其余三组,镇静深度也明显较其余三组过深。D2、D3组的呛咳评分和躁动评分都令人满意,明显低于C组和D1组。结论：术前静脉注射地佐辛0.2mg/kg超前镇痛用于妇科腹腔镜手术患者术后苏醒期的VAS镇痛效果好,Ramesay系统评分满意,不影响患者清醒时间和拔管时间,术后镇痛效果确切,不良反应发生率少。
[Abstract]:Objective: to investigate the effect of different doses of dizosin preemptive analgesia on the recovery quality of patients undergoing general anesthesia and gynecological laparoscopic surgery. Methods: one hundred and twenty patients undergoing gynecologic laparoscopic surgery under general anesthesia were randomly divided into 4 groups (n = 30): group D _ 2 (dizosin 0.1mg/kg), group D _ 2 (0.2mg/kg), group D _ 3 (0.3mg/kg) and group C (normal saline 2m1). Five minutes before anesthesia induction, D1, D2, D3 and C groups received intravenous injection of dizosin 0.1 mg / kg, 0.2 mg / kg, 0.3 mg / kg and 2 mg / kg normal saline, respectively. Anesthesia induction and maintenance were performed with propofol, remifentanil and rocuronium. The operation time, PACU, lmin after extubation (T _ 1), 5min (T _ 3) after extubation and 10min (T _ 4) after extubation were recorded. Extubation time, sedation score, cough score, restlessness score and other adverse reactions. Results the SBP HR of the two groups was significantly lower than that of the C and D1 groups, and the SPO _ 2N _ R of the D _ 3 group was significantly lower than that of the other three groups, and the VAS score of the control group was superior to that of the C and D _ 1 groups, and the postoperative analgesia effect was more satisfactory. But the postoperative waking time and extubation time of D3 group were significantly longer than those of the other three groups, and the sedation depth of D3 group was significantly higher than that of the other three groups. The score of cough and restlessness in D3 group was significantly lower than that in C group and D1 group. Conclusion: preoperative intravenous dizosin 0.2mg/kg preemptive analgesia is effective for postoperative VAS analgesia in patients undergoing gynecological laparoscopic surgery during the recovery period. The effect of VAS system is satisfactory and does not affect the patient's waking time and extubation time. The postoperative analgesia effect is accurate. The incidence of adverse reactions was low.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614

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