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当前位置: 首页 > 文章 > 不同剂量地佐辛预防瑞芬太尼快速耐受的临床观察 河北北方学院学报(自然科学版) 2014 (1) 80-83
Position: Home > Articles > Clinical Investigation on Different Doses of Dezocine in Preventing Rapid Tolerance of Remifentanil Journal of Hebei North University(Natural Science Edition) 2014 (1) 80-83

不同剂量地佐辛预防瑞芬太尼快速耐受的临床观察

作  者：
樊娟;李爱军;赵玮;李福龙
单  位：
河北北方学院附属第一医院麻醉科;河北北方学院附属第一医院小儿外科
关键词：
地佐辛;瑞芬太尼;阿片耐受;痛觉过敏
摘  要：
目的与芬太尼对照观察不同剂量地佐辛对预防瑞芬太尼快速耐受所致术后痛觉过敏的效果。方法 80例ASAⅠ~Ⅱ级行择期脊柱手术患者随机分为A组(地佐辛0.1mg·kg-1组)、B组(地佐辛0.2mg·kg-1组)、C组(地佐辛0.3mg·kg-1组)、D组(芬太尼1μg·kg-1组)。各组患者均采用静脉复合麻醉,术中连续监测血流动力学变化,记录各组苏醒时间、拔管时间、拔管时患者的血流动力学指标、苏醒后的VAS评分、Ramsay评分及要求镇痛距离拔管的时间、拔管后患者恶心呕吐、烦躁及呼吸抑制等情况。结果各组患者拔管时MAP、HR比较差异无统计学意义(P>0.05);A、B、C三组自主呼吸恢复时间、苏醒时间及拔管时间均较D组短;要求镇痛距离拔管的时间B、C组较D组长,差异有统计学意义,(P<0.05),A组与D组相比,差异无统计学意义,(P>0.05);苏醒后VAS评分A组T1时点及B、C组各时点较D组小,差异有统计学意义,(P<0.05);C组各时点与D组相比,Ramsay评分4分例数最多(18,15,13,9,5例),差异有统计学意义,(P<0.05);不良反应中呼吸抑制发生率D组最高,为6例(30%),其次C组,为2例(10%);恶心呕吐发生率D组最高,为5例(25%);各组患者均未出现烦躁。结论地佐辛可安全有效减轻瑞芬太尼麻醉后快速耐受所致术后痛觉过敏,临床麻醉更有效、更安全。
译  名：
Clinical Investigation on Different Doses of Dezocine in Preventing Rapid Tolerance of Remifentanil
作  者：
FAN Juan;LI Ai-jun;ZHAO Wei;Department of Anesthesiology,The First Affiliated Hospital,Hebei North University;Department of Pediatric Surgery,The First Affiliated Hospital,Hebei North University;
关键词：
dezocine;;remifentail;;opioid tolerance;;hyperalgesia
摘  要：
Objective to observe the effect of dezocine with different doses on preventing post-operative hyperalgesia caused by rapid tolerance of remifentanil,compared with that of fentanyl.Methods 80 patients(ASA Ⅰ ~ Ⅱ)undergoing spinal surgery were randomly divided into four groups,group A(dezocine 0.1mg·kg-1),group B(dezocine 0.2 mg·kg-1),group C(dezocine 0.3 mg·kg-1)and group D(fentanyl 1μg·kg-1).All patients in four groups were treated with intravenous inhalation compound anesthesia,while hemodynamic changes were continccously monitored,and awake and extubation time,patients′hemodynamic parameters in extubation period,VAS and Ramsay score after awake were recorded.Meanwhile,the time required by analgesic,nausea and vomiting,irritability and respiratory depression after extubation were also observed.Results The differences of MAP and HR among four groups in extubation period were not statistically significant(P>0.05);spontaneous breathing recovery time,awake time and extubation time among group A,B,C were shorter than those of group D;time required by analgesic after extubation in group B,C was longer than that group D and the difference was statistically significant(P<0.05);but for group A the difference was not statistically significant(P>0.05); compared with that of Group D,each moment in group B,C was smaller than that of group D and the difference was statistically significant(P<0.05).Compared with that of group D,the number of patients whose Ramsay score was 4at each moment in group C was more(18,15,13,9,5cases)and the difference was statistically significant,(P<0.05).The incidence of respiratory depression in Group D(6 cases,30%)was highest,followed by Group C with two cases(10%);The highest incidence of nausea and vomiting was in group D(5cases,25%).but no patients in four groups was irritable.ConclusionDezocine could reduce post-operative hyperalgesia caused by remifentanil rapid tolerance safely and effectively.Clinical anesthesia is more effective and safer.

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