地佐辛与芬太尼用于硬膜外阻滞下阑尾切除术中抑制牵拉反应的临床观察.pdf

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1、西北国防医学杂志2012年4月30日第33卷第2期MedJNDFNC，VOL．33，NO．2，April，2012123地佐辛与芬太尼用于硬膜外阻滞下阑尾切除术中抑制牵拉反应的临床观察焦向阳，贺显建，薛璋明，曾甜(解放军323医院麻醉科，陕西西安710054)[摘要]目的：观察地佐辛与芬太尼在硬膜外阻滞下阑尾切除术中，抑制牵拉反应的临床效果和安全性。方法：选择硬膜外下拟行阑尾切除术患者60例，随机分为观察组和对照组，每组各3O例。硬膜外阻滞效果确切后开始手术前，观察组缓慢静推地佐辛o．1mg／kg+托烷司琼2mg，然后持续泵注地佐辛

2、1．5～2txg／(kg·min)至关腹。对照组缓慢静推芬太尼1kg+托烷司琼2mg，然后持续泵注芬太尼0．2—0．3g／(kg·min)至关腹。分别于手术前、切皮时、切开腹膜时、牵拉阑尾时、手术结束时监测患者SBP、DBP、HR、SpO的变化，并对内脏牵拉反应状况进行评估。结果：切开腹膜时、牵拉阑尾时，观察组与对照组比较差异无统计学意义(P>0．05)。结论：地佐辛与芬太尼在硬膜外阻滞下阑尾切除术中，都具有良好的抑制牵拉反应作用；地佐辛安全性更高。[关键词]麻醉学；地佐辛；芬太尼；阑尾切除术[中图分类号]R614．42[文献标识码

3、]A[文章编号]1007—8622(2012)02—0123—02InhibitoryeffectofdezocineandfentanylonvisceraltractionreactionduringappendectomyunderepiduralanesthesiaJIAOXiang—yang，HEXian—jian，XUEZhang—ming，eta1．(DepartmentofAnesthesiology，the323HospitalofPLA，Xihn710054，China)[Abstract]Objective：T

4、ostudytheeffectandsafetyofdezocineandfentanylforinhibitingthevisceraltractionreactionduringappendectomyunderepiduralanesthesia．Methods：Sixtypatientsundergoingappendectomyunderepiduralanesthesiawererandomlydividedintotheobservationgroup(n=30)andthecontrolgroup(n=30)．Aft

5、erepiduralanesthesia，thepatientsinobservationgroupwereslowlygivendezocine(0．1mg／kg)andtropise—tron2mgbyintravenousinjection，thengivencontinuallydezocine1．5—2~xg／kg／minbypumptilltheendofthesurgery．Thepatientsincontrolgroupwereslowlygivenfentanyl1kgandtropisetron2mg，then

6、givendezocine0．2—0．3g／kg／mincontinuallybypumptilltheendofthesurgery．ThevitalsignsincludingSBP，DBP，HRandSpO2wererecordedbeforeoperation，atthetimepointsofcuttingtheskin，openingtheperitonealcavityandpullingappendix，andattheendofoperation．Thevisceraltractionreactionwaseval

7、uatedduringoperation．Results：Atthetimepointsofopeningtheperitonealcavityandpullingappendix，therewasnosignificantdifferencebetweentheobservationgroupandthecontrolgroup(P>0．05)．Conclusion：Bothdezocineandfentanylaresig-nificantlyeffectiveforinhibitingthevisceraltractionre

8、actionduringappendectomyunderepiduralanesthesia，anddezocinemaybemoresafeforit．[Keywords]Anesthesiology；Dezocine；Fenta