地佐辛对预防全麻插管苏醒期躁动的疗效观察-麻醉学专业论文.docx

汕头大学医学院硕士学位论文 汕头大学医学院硕士学位论文 II II 不良反应发生率较芬太尼组低（P0.05）。 结论： 1. 芬太尼(1μg·kg-1)和地佐辛(0.1 mg·kg-1)均能通过较为满意的术后镇痛有效地 降低术后全麻苏醒期躁动的发生率； 2. 地佐辛（0.1 mg·kg-1）相对芬太尼(1μg·kg-1)安全，对病人自主呼吸的影响较 轻微； 3. 地佐辛（0.1 mg·kg-1）的不良反应发生率较芬太尼(1μg·kg-1)少。 因此，丙泊酚联合瑞芬太尼维持的全麻手术在结束前约 8~20 min 静脉注射地佐辛 0.1 mg·kg-1 能通过有效镇痛减少患者在苏醒期的躁动发生率，使病人在苏醒期血流动力学趋 于稳定，病人更舒适，对术后呼吸运动影响轻微，不良反应发生率较低，避免了使用芬太 尼发生呼吸抑制及延迟性呼吸抑制的潜在风险，从而提高了全麻术后苏醒质量，值得在临 床推广。 关键词 地佐辛；全身，麻醉；苏醒期，躁动 PAGE PAGE III Abstract Objective: To investigate the effect of dezocine on preventing emergence agitation(EA). Methods: One hundred and eighty patients, American Society of Anesthesiologists (ASA) status Ⅰ to Ⅱ, undergoing elective surgeries under general anesthesia, were randomly divided into three groups: Group NS, Fentanyl and Dezocine. All patients were undergone general anesthesia with propofol-remifentanil. After successfully intubation with regular induction of anesthesia, patients were administered with propofol, cisatracurium and remifentanil constantly during maintenance of anesthesia, and ventilated with anesthesia machines. Then normal saline 2 mL, fentanyl 1 μg·kg-1 and dezocine 0.1 mg·kg-1 were administered in three groups respectively by intravenous injection about 8～20 minutes before operations ended. Then the level of restlessness and pain scores during analepsia period were assessed. Spontaneous breath recovery time, extubation time, respiratory rate at 5 minutes after extubation, and side-effects as well among groups were recorded. Results: The restlessness scores of both Fentanyl Group and Dezocine Group were less than those of NS Group (P0.05). While the difference between Fentanyl Group and Dezocie Group was not statistically significant (P0.05). Comparison of pain scores at 5 minutes after extubation among 3 groups showed that patients in Fentanyl Group and Dezocine Group experienced less postoperative pain than those who in NS Group(P0.05), while analgesic efficacy was similar in both Fentanyl Group and Dezocin Group(P0.05). D