地佐辛对肝炎肝硬化患者瑞芬太尼麻醉后痛觉超敏的影响.docVIP

精品论文 参考文献 地佐辛对肝炎肝硬化患者瑞芬太尼麻醉后痛觉超敏的影响 （东南大学附属第二医院麻醉科，江苏南京，210003） 摘要 目的 观察地佐辛在肝炎肝硬化患者手术中的应用，评价其对瑞芬太尼麻醉后痛觉超 敏的影响。方法 选择择期在全身麻醉下行脾切术的肝炎肝硬化患者120例,采用随机数学表法,将患者均分为四组，每组30例。D1、D2、D3组，分别静注地佐辛0.1、0.15、0.2mg/kg；F组静注芬太尼1mu;g/kg。记录苏醒时间、拔除气管导管时间，T0～2的VAS、BCS、SAS,观察呼吸抑制、恶心呕吐等发生情况。结果 与F组相比,D1、D2、D3组的苏醒时间、拔除气管导管时间明显缩短,呼吸抑制、恶心呕吐的发生率显著降低(P＜0.05)；同时，D1组各时点VAS评分增高,BCS评分降低,D2组T1～2时VAS评分降低,D3组T0～2时VAS、SAS评分降低 (P＜0.05)；与D2组比较,D3组T0～2时SAS评分降低,呼吸抑制的发生率增高(P＜0.05)。结论 在缝皮前15min，静注地佐辛0.15mg/kg，能够有效地预防与缓解瑞芬太尼麻醉后的急性疼痛,且不良反应少，可安全地应用于肝炎肝硬化患者。 关键词 地佐辛；肝炎肝硬化患者；瑞芬太尼；痛觉超敏 Effects of dezocine with different doses in patients with hepatitis cirrhosis of the liver on allodynia induced by remifentanil intravenous anesthesia 通信作者：殷国平，Email:yinguoping0304@163.com ZHUO Jiu-wu ,YIN Guo-ping, DENG You-ming (Department of Anesthesiology, The Second Hospital Of Affiliated to DongnanUniversity ,210003,Jiangsu China) Abstract Objective To dscuss the effects of dezocine with different doses in patients with hepatitis cirrhosis of the liver on allodynia induced by remifentanil intravenous anesthesia. Methods One hundred and twenty patients , undergoing partial resection of hepatocellular carcinoma within generai analgesia, were randomly divided into four groups .The emergence time and extubation time were recorded. VAS,BCS and SAS at T0,1,2,and the incidence of respiratory depression, nausea and vomiting after extubation were recorded. Results Compared with group F, the emergence time and extubation time were shortened, the incidence of respiratory depression and nausea and vomiting was decreased in groups D1、D2 and D3,VAS was increased and BCS was decreased at T0-2 ,VAS at T1-2 was decreased ,while VAS and SAS score at T0-2 was decreased in groups D3.Compared with group D2,SAS score was decreased at T0-2,while the incidence of respiratory depression was increased in group D3 . Conclusion Intravenous injection of dezocine 0.15 mg/kg at 30 min before suture of skin could remission allodynia with little side ef