地佐辛联合罗哌卡因局部麻醉预处理对腹腔镜下胆囊切除术男性患者苏醒期躁动的影响(1)
[摘要] 目的 探讨地佐辛联合罗哌卡因局部麻醉预处理对腹腔镜下胆囊切除术(LC)男性患者苏醒期躁动的影响。方法 选择2014年1～12月于江山市人民医院择期行LC的男性患者60例，随机分为治疗组和对照组，每组各30例。两组麻醉诱导及维持方法相同，治疗组在手术结束前20 min静脉注射地佐辛0.1 mg/kg，手术结束后0.75%盐酸罗哌卡因行切口局部浸润麻醉，对照组不予处理。术后转入麻醉恢复室。观察两组术后苏醒时间、拔管时间；记录术后苏醒期躁动发生率和程度；记录麻醉前(T0)、拔管前(T1)、拔管后5 min(T2)、拔管后10 min(T3)、拔管后30 min(T4)、拔管后1 h(T5)的收缩压(SBP)、舒张压(DBP)、心率(HR)、血氧饱和度(SpO2)；在拔管后30 min、1 h、4 h、12 h各时间点对患者进行视觉模拟评分(VAS)；并观察患者导尿管不适程度及恶心呕吐等不良反应。 结果 与T0比较，对照组在T1、T2、T3、T4、T5时SBP、DBP、HR均升高(P < 0.05)；治疗组在T1、T2、T3、T4、T5各时点的SBP、DBP、HR均低于对照组(P < 0.05)；治疗组清醒后导尿管无不适(0级)患者21例(70%)，多于对照组的3例(10%)(P < 0.01)；治疗组在拔管后30 min、1 h、4 h VAS评分低于同时间点的对照组(P < 0.05或P < 0.01)；治疗组安静无烦躁(0级)患者23例(76.67%)，多于对照组的5例(16.67%)(P < 0.01)。 结论 地佐辛联合罗哌卡因局部浸润麻醉预处理能有效预防LC男性患者苏醒期躁动，提高患者的舒适度，不延长苏醒时间。
[关键词] 苏醒期躁动；地佐辛；腹腔镜下胆囊切除术；局部麻醉；罗哌卡因
[中图分类号] R614.24 [文献标识码] A [文章编号] 1673-7210(2016)03(a)-0072-04
Effect of combination of Dezocine and Ropivacaine preconditioning on preventing emergence agitation in male patients undergoing laparoscopic cholecystectomy
JIANG Jingwei LU Huarong ZHOU Zhaowen HUANG Jianbo
Department of Anesthesiology， Jiangshan People's Hospital， Zhejiang Province， Jiangshan 324100， China
[Abstract] Objective To observe the effect of combination of Dezocine and Ropivacaine preconditioning on preventing emergence agitation (EA) in male patients undergoing laparoscopic cholecystectomy. Methods Sixty male patients undergoing laparoscopic cholecystectomy in Jiangshan People's Hospital from January to December 2014 were selected. All patients were randomly divided into treatment group and control group， each group with 30 cases. Patients of the two groups were given same induction and maintenance of anesthesia， and patients of the treatment group were given Dezocine (0.1 mg/kg) infused for 20 minutes before the end of surgery， and 0.75% Ropivacaine hydrochloride used for local anesthesia at incision after surgery， while the control group was not be processed. They were sent to anesthesia recovery room after the surgery. Awakening time， extubation time of the two groups were observed； incidence and degree of EA after operation were recorded； SBP， DBP， HR， SpO2 were recorded before induction (T0)， before extubation (T1)， and 5 min (T2)， 10 min (T3)， 30 min (T4)， 1 h (T5) after extubation. Pain degree was assessed with visual analog scale (VAS) at the time of 30 min， 1 h， 4 h， 12 h after extubation. Adverse reactions of catheter discomfort， nausea and vomiting were also recorded. Results Compared with T0， SBP， DBP， HR at T1， T2， T3， T4， T5 were higher than those of the control group (P < 0.05). SBP， DBP， HR at T1， T2， T3， T4， T5 in treatment group were lower than those of the control group at corresponding time points (P < 0.05). Patients of catheter comfort in treatment group [21(70%)] were more that of control group [3(10%)] (P < 0.01). The VAS scores in treatment group at 30 min， 1 h， 4 h， 12 h after extubation were less than those of the control group (P < 0.05 or P < 0.01). Quiet and no fidgety patients (degree 0) in treatment group [23(66.67%)] were more than that of the control group [5(16.67%)] (P < 0.01). Conclusion Dezocine and Ropivacaine preconditioning can prevent EA in male patients undergoing laparoscopic cholecystectomy， and improve patients' comfort， and not extend the time of awakening., http://www.100md.com(姜景卫 鲁华荣 周召文 黄建波)
[关键词] 苏醒期躁动；地佐辛；腹腔镜下胆囊切除术；局部麻醉；罗哌卡因
[中图分类号] R614.24 [文献标识码] A [文章编号] 1673-7210(2016)03(a)-0072-04
Effect of combination of Dezocine and Ropivacaine preconditioning on preventing emergence agitation in male patients undergoing laparoscopic cholecystectomy
JIANG Jingwei LU Huarong ZHOU Zhaowen HUANG Jianbo
Department of Anesthesiology， Jiangshan People's Hospital， Zhejiang Province， Jiangshan 324100， China
[Abstract] Objective To observe the effect of combination of Dezocine and Ropivacaine preconditioning on preventing emergence agitation (EA) in male patients undergoing laparoscopic cholecystectomy. Methods Sixty male patients undergoing laparoscopic cholecystectomy in Jiangshan People's Hospital from January to December 2014 were selected. All patients were randomly divided into treatment group and control group， each group with 30 cases. Patients of the two groups were given same induction and maintenance of anesthesia， and patients of the treatment group were given Dezocine (0.1 mg/kg) infused for 20 minutes before the end of surgery， and 0.75% Ropivacaine hydrochloride used for local anesthesia at incision after surgery， while the control group was not be processed. They were sent to anesthesia recovery room after the surgery. Awakening time， extubation time of the two groups were observed； incidence and degree of EA after operation were recorded； SBP， DBP， HR， SpO2 were recorded before induction (T0)， before extubation (T1)， and 5 min (T2)， 10 min (T3)， 30 min (T4)， 1 h (T5) after extubation. Pain degree was assessed with visual analog scale (VAS) at the time of 30 min， 1 h， 4 h， 12 h after extubation. Adverse reactions of catheter discomfort， nausea and vomiting were also recorded. Results Compared with T0， SBP， DBP， HR at T1， T2， T3， T4， T5 were higher than those of the control group (P < 0.05). SBP， DBP， HR at T1， T2， T3， T4， T5 in treatment group were lower than those of the control group at corresponding time points (P < 0.05). Patients of catheter comfort in treatment group [21(70%)] were more that of control group [3(10%)] (P < 0.01). The VAS scores in treatment group at 30 min， 1 h， 4 h， 12 h after extubation were less than those of the control group (P < 0.05 or P < 0.01). Quiet and no fidgety patients (degree 0) in treatment group [23(66.67%)] were more than that of the control group [5(16.67%)] (P < 0.01). Conclusion Dezocine and Ropivacaine preconditioning can prevent EA in male patients undergoing laparoscopic cholecystectomy， and improve patients' comfort， and not extend the time of awakening., http://www.100md.com(姜景卫 鲁华荣 周召文 黄建波)