地佐辛联合丙泊酚在乳腺区段切除术中应用.docVIP

地佐辛联合丙泊酚在乳腺区段切除术中应用 　　【摘要】 目的 观察地佐辛联合丙泊酚用于乳腺区段切除术的效果和安全性。方法 60例ASAⅠ～Ⅱ级的女性患者， 随机分为D组和C组， 每组30例。D组患者静脉注射地佐辛诱导， C组患者静脉注射芬太尼诱导， 两组麻醉维持均用丙泊酚。记录两组患者诱导前、诱导后、切皮时、术中（手术开始后10 min）、术毕各时间点的平均动脉压（MAP）、心率（HR）的变化， 以及有无恶心呕吐、头痛头晕、术中体动、术中知晓、术后疼痛等不良反应。结果 两组患者诱导后的MAP低于诱导前， 差异有统计学意义（P0.05）， D组患者不良反应发生率20%低于C组40%， 差异有统计学意义（P0.05）。结论 地佐辛联合丙泊酚可以安全用于乳腺区段切除术。 　　【关键词】 地佐辛；丙泊酚；乳腺区段切除；麻醉 　　DOI：10.14163/j.cnki.11-5547/r.2015.30.008 　　Application of dezocine combined with propofol in segmental mastectomy XING Fang， LI Jia. Department of Anesthesiology， Affiliated Tumor Hospital of Zhengzhou University， Zhengzhou 450008， China 　　【Abstract】 Objective To observe effect and safety of dezocine combined with propofol applied in segmental mastectomy. Methods A total of 60 female patients with ASA Ⅰ～Ⅱ were randomly divided into group D and group C， with 30 cases in each group. Group D received dezocine by intravenous injection for induction， and group C received fentanyl by intravenous injection for induction. Both groups received propofol for anesthetic maintenance. Changes of mean arterial pressure （MAP） and heart rate （HR） were recorded in the two groups before and after induction， during skin incision， in operation （10 min after operation beginning） and at the end of operation. Adverse reactions of nausea and vomiting， headache and dizziness， intraoperative body movement， intraoperative awareness， and postoperative pain were also recorded. Results Both groups had lower MAP after induction than those before induction， and the difference had statistical significance （P0.05）. Group D had lower incidence of adverse reactions as 20% than 40% of group C， and the difference had statistical significance （P0.05）. Conclusion Application of dezocine combined with propofol is safe in segmental mastectomy. 　　【Key words】 Dezocine； Propofol； Segmental mastectomy； Anesthesia 　　乳腺区段切除主要用于良性乳腺病变的治疗及疑似恶性病变的诊断， 由于此类手术位于胸壁体表， 对肌松要求不高， 仅需充分镇静镇痛即可[1]， 地佐辛是一种新型阿片受体混合激动-拮抗剂， 由于其镇痛作用强、呼吸抑制轻和药物依赖发生率低， 近年来已用于临床麻醉和镇痛。本研究