摘要
目的:探讨Narcotrend监测下地佐辛在鼻内镜手术术前、术中分别给药及术前术中联合给药对麻醉效果的影响。方法:选取2017年1月—2018年12月于汕头大学医学院第二附属医院行鼻内镜下鼻道手术患者120例,ASA分级Ⅰ~Ⅱ级,年龄20~60岁。按地佐辛不同给药时机随机分为空白对照组(N0组)、术前给药组(N1组)、术中给药组(N2组)、术前及术中联合给药组(N3组),每组30例。各组麻醉方案及控制性降压方法一致,维持相同的麻醉深度。记录各组患者各时间点的平均动脉压、手术时间、出血量、自主呼吸恢复时间、拔管时间、使用硝酸甘油降压例数及硝酸甘油用量,采用Ramsay镇静评分评价患者术后镇静程度,采用视觉模拟评分法(VAS)评价患者苏醒后的疼痛程度。结果:N1~N3组患者与N0组相比,术后Ramsay镇静评分均增加(均P<0.05),VAS评分和术中硝酸甘油的用量均减少(均P<0.05);N1组患者与其他组相比,术后自主呼吸恢复时间、苏醒时间、拔管时间均减少(均P<0.05);N2组患者与其他组相比,术后自主呼吸恢复时间、苏醒时间、拔管时间均增加(均P<0.05),VAS评分减少(P<0.05)。结论:在Narcotrend监测下使用地佐辛能减少鼻内镜手术中降压药物的使用,缓解术后疼痛,减少苏醒期躁动。术前给予地佐辛能够降低麻醉复苏时间,术中给予地佐辛虽然会延长麻醉复苏时间,但能减少患者术后疼痛。
Objective:To investigate the effect of dizocine on anesthetic effect in nasal endoscopic surgery with preoperative,intraoperative and both preoperative and intraoperative administration combined under the monitoring of Narcotrend.Methods:From January 2017 to December 2018,120 patients who underwent nasal endoscopic surgery in the Second Affiliated Hospital of Shantou University Medical College were selected,ASA gradeⅠtoⅡ,age 20 to 60 years old.According to the different timing of dezocine administration,they were randomly divided into blank control group(N0 group),preoperative administration group(N1 group),intraoperative administration group(N2 group),preoperative and intraoperative combined administration group(N3 Group),30 cases in each group.The anesthesia plan and controlled blood pressure reduction method of each group were the same,maintaining the same depth of anesthesia.The average arterial pressure,operation time,blood loss,spontaneous breathing recovery time,extubation time,the number of cases of using nitroglycerin to lower blood pressure,and the amount of nitroglycerin at each time point of each group were recorded.The Ramsay score was used to evaluate the degree of postoperative sedation.The visual analogue scale(VAS)evaluates the degree of pain after the patient wakes up.Results:Compared with the N0 group,the Ramsay scores of the patients in the N1-N3 group were all increased(P<0.05),the VAS score and the intraoperative nitroglycerin dosage were all reduced(P<0.05).Compared with other groups,the postoperative spontaneous breathing recovery time,awakening time,and extubation time of the patients in the N1 group were all reduced(P<0.05).Compared with other groups,the postoperative spontaneous breathing recovery time,waking time,and extubation time of the patients in the N2 group were all increased(P<0.05),the VAS score was decreased(P<0.05).Conclusion:The use of dezocine under the monitoring of Narcotrend can reduce the use of antihypertensive drugs in nasal endoscopic surgery,relieve postoperati
作者
王肯如
林宏彬
杜瑞明
游志坚
WANG Kenru;LIN Hongbin;DU Ruiming;YOU Zhijian(Department of Anesthesiology,the Second Affiliated Hospital of Shantou University Medical College,Shantou 515000,China)
出处
《汕头大学医学院学报》
2020年第4期217-220,共4页
Journal of Shantou University Medical College
