摘要
目的评价喷他佐辛超前镇痛对脊柱外科内固定手术苏醒期应激反应的影响,为临床的合理用药提供参考。方法选择2012年该院脊柱外科内固定手术80例,ASAⅠ、Ⅱ级,年龄30~75岁。随机分成空白对照组（A组）、小剂量喷他佐辛组（B1组）、中剂量喷他佐辛组（B2组）及大剂量喷他佐辛组（B3组）。每组20例。B1、B2和B3组在全身麻醉诱导后静脉分别给予喷他佐辛0.6、1.2和1.8 mg/kg,观察并记录拔管即刻（T1）、拔管后3 min（T2）、5 min（T3）、10 min（T3）、15 min（T4）的镇静躁动评分（SAS）、平均动脉压（MAP）、心率（HR）与血浆皮质醇水平（Cor）、拔管时间、苏醒时间,以及患者术后12 h呼吸抑制、恶心、呕吐等不良反应。结果与A组相比,其余3组T1~T4的SAS评分、MAP、HR、Cor下降,差异有统计学意义（P〈0.05）;与B1组相比,B2组,B3组T1~T4的SAS评分、MAP、HR、Cor下降,差异有统计学意义（P〈0.05）,B2与B3组T1~T4的SAS评分、MAP、HR、Cor差异无统计学意义（P〉0.05）,A、B1、B2组苏醒时间、拔管时间差异无统计学意义（P〉0.05）,与A、B1、B2组比较,B3组苏醒时间和拔管时间延长,且呼吸抑制、恶性呕吐不良反应的发生率高,差异有统计学意义（P〈0.05）。结论 1.2 mg/kg剂量的喷他佐辛超前镇痛明显减轻脊柱外科内固定手术全身麻醉苏醒期的应激反应,且不良反应的发生率低。
[Objective] To evaluate Pentazocine preemptive analgesia of spinal fixation surgery recovery period stress response for clinical rational drug reference. [Methods] Select 2012 in our hospital spinal fixa- tion surgery 80 cases,ASA I ~ ]][ grade,aged 30 to 75 years old. Were randomly divided into four groups of 20 each： control group （A）, low-dose Pentazocine group （B1 group）, medium-dose Pentazocine group （B2 group）, high-dose Pentazocine group （B3 group）. B1, B2 and B3 groups after induction of anesthesia were giv- en intravenous Pentazocine 0.6 mg/kg, 1.2 mg/kg, 1.8 mg/kg, four groups were observed and recorded extubation （T~）, after extubation 3 min （T2）, 5 min （T3）, 10 min （T3）, 15 min （T4） sedation agitation score （SAS）, mean arte- rial pressure （MAP）, heart rate （HR） and plasma cortisol （Co0, extubation time, recovery time, and 12 hours postoperative respiratory depression, nausea, vomiting and other adverse reactions. [Results] Compared with group A, and the remaining three groups T~ ~ T4, SAS score, MAP, HR, Cor decreased, the difference was statistically significant （P〈0.05）; compared with Bl, B2 group, B3 group T1-T4, SAS score, MAP, HR, Cor decreased, the difference was statistically significant （P〈0.05）, BE and B3 group T1-T4, SAS score, MAP, HR, Cor difference was not statistically significant （P〉0.05）, A,B1, B2 group recovery time, extubation time differ-ence was not statistically significant （P〉0.05）, and A, B1, B2 group, B3 group, prolonged recovery time and extubation and respiratory depression, nausea and vomiting incidence of adverse reactions, the difference was statistically significant （P〈0.05）. [Conclusion] 1.2 mg/kg dose pentazocine preemptive analgesia significantly reduced spinal fixation surgery anesthesia recovery period of the stress response, and the low incidence of ad- verse reactions.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2014年第2期87-90,共4页
China Journal of Modern Medicine
