论文部分内容阅读
目的 比较不同剂量地佐辛用于腹腔镜手术镇痛对患者复苏期间呼吸的影响.方法 从病历数据库选择126例择期腹腔镜手术患者,分为3组:地佐辛5 mg(D1)组,地佐辛10 mg(D2)组和氟比洛芬酯(K)组,每组42例.D1组:手术开始时静脉推注地佐辛5 mg;D2组:手术开始时静脉推注地佐辛5 mg,术中再静脉滴注5 mg;K组:手术开始时静脉推注氟比洛芬酯50 mg,手术结束前再静脉推注50 mg.术毕所有患者苏醒并拔除气管导管后进入复苏室进行心电监护,并评估疼痛、镇静程度,记录恶心、呕吐、寒战等的发生情况.结果 3组患者术后的Ramsay评分,VAS以及恶心呕吐、寒战、心动过速发生率之间差异均无统计学意义(P＞0.05).围拔管期高血压发生率由低到高依次为D2组、D1组和K组.DI组和D2组术后呼吸抑制发生率高于K组(P ＜0.05);D1组和D2组术后呼吸抑制发生率之间差异无统计学意义(P＞0.05).结论 地佐辛增加术后呼吸抑制发生率,但5 mg和10 mg组之间差异无统计学意义.地佐辛能有效预防围拔管期高血压,10 mg组优于5mg组.术后应严密心电监护,积极应对呼吸抑制的发生.“,”AIM To compare different doses of dezocine on breathing during recovery of patienots for laparoscopic surgery analgesia.MTHEODS A total of 126 patients collected from the case database treated with dezocine and flurbiprofen axetil injection were divided into 3 groups.In group K (42 cases),50 mg flurbiprofen axetil injection was intravenously injected when surgery started,50 mg before surgery ended,totally 100 mg used.Group D(84 cases) was divided into group D1 (5 mg,42 cases) and group D2(10 mg,42 cases).In group D1,5 mg dezocine intravenously injected before surgery.In group D2,5 mg dezocine intravenously injected when surgery started,5 mg before surgery ended,totally 10 mg used.After surgery,patients awakened and were extubated,and then sent to postanesthesia care unit (PACU).The instrument of heart electricity guardian was applied to monitor patient's blood oxygen saturation degree to observe the patient's consciousness,record VAS,Ramsay sedative score and the adverse drug reaction during PACU.RESULTS Comparison of general information,the VAS,Ramsay sedative score,nausea,vomiting,chills and rate of tachycardia were no statistically significant (P ＞ 0.05) in 3 groups.The incidence of hypertension in the perioperative period from low to high was group D2,group D1 and group K,respectively.Group D1 and group D2 had a higher incidence of respiratory depression than group K (P ＜ 0.05),but there was no statistically significant between group D1 and group D2.CONCLUSION Dezocine has a higher incidence of postoperative respiratory dysfunction,but there is no statistically significant between 5 mg and 10 mg groups.Dezocine could effectively prevent hypertensive response during perioperative period,but 10 mg group is better than 5 mg group.Therefore,closely observing electrocardiographic monitoring is needed to prevent respiratory depression in PACU.