發(fā)布時間：2018-08-07 06:56

【摘要】：目的：探討不同劑量地佐辛超前鎮(zhèn)痛對全麻婦科腹腔鏡手術(shù)患者術(shù)后蘇醒期質(zhì)量的影響。 方法：選擇擇期全身麻醉下行婦科腹腔鏡手術(shù)患者120例,隨機分為4組(n=30)：D1組(地佐辛0.1mg/kg),D2組(地佐辛0.2mg/kg), D3組(地佐辛0.3mg/kg)和對照組C組(生理鹽水2m1)。麻醉誘導(dǎo)前5min, D1、 D2、D3組和C組分別靜脈靜推地佐辛0.1mg/kg、0.2mg/kg、0.3mg/kg和生理鹽水2m1。然后以丙泊酚、瑞芬太尼及羅庫溴銨進行麻醉誘導(dǎo)和術(shù)前麻醉維持,記錄四組患者手術(shù)時間,入PACU時(T0)、拔管前(T1)、拔管后lmin (T2)、拔管后5min(T3)和拔管后10min(T4)的SBP、DBP、MBP、HR、 SpO2、R、VAS評分和清醒時間、拔管時間、鎮(zhèn)靜評分、嗆咳評分、躁動評分及其他不良反應(yīng)。 結(jié)果：D2、D3組的SBP、HR明顯低于C組和D1組,且更平穩(wěn)；而D3組的SpO2、R明顯低于其余三組,易產(chǎn)生呼吸抑制。VAS評分：D2、D3組的VAS評分優(yōu)于C組和D1組,術(shù)后鎮(zhèn)痛效果更滿意。但D3組的術(shù)后清醒時間和拔管時間明顯長于其余三組,鎮(zhèn)靜深度也明顯較其余三組過深。D2、D3組的嗆咳評分和躁動評分都令人滿意,明顯低于C組和D1組。 結(jié)論：術(shù)前靜脈注射地佐辛0.2mg/kg超前鎮(zhèn)痛用于婦科腹腔鏡手術(shù)患者術(shù)后蘇醒期的VAS鎮(zhèn)痛效果好,Ramesay系統(tǒng)評分滿意,不影響患者清醒時間和拔管時間,術(shù)后鎮(zhèn)痛效果確切,不良反應(yīng)發(fā)生率少。
[Abstract]:Objective: to investigate the effect of different doses of dizosin preemptive analgesia on the recovery quality of patients undergoing general anesthesia and gynecological laparoscopic surgery. Methods: one hundred and twenty patients undergoing gynecologic laparoscopic surgery under general anesthesia were randomly divided into 4 groups (n = 30): group D _ 2 (dizosin 0.1mg/kg), group D _ 2 (0.2mg/kg), group D _ 3 (0.3mg/kg) and group C (normal saline 2m1). Five minutes before anesthesia induction, D1, D2, D3 and C groups received intravenous injection of dizosin 0.1 mg / kg, 0.2 mg / kg, 0.3 mg / kg and 2 mg / kg normal saline, respectively. Anesthesia induction and maintenance were performed with propofol, remifentanil and rocuronium. The operation time, PACU, lmin after extubation (T _ 1), 5min (T _ 3) after extubation and 10min (T _ 4) after extubation were recorded. Extubation time, sedation score, cough score, restlessness score and other adverse reactions. Results the SBP HR of the two groups was significantly lower than that of the C and D1 groups, and the SPO _ 2N _ R of the D _ 3 group was significantly lower than that of the other three groups, and the VAS score of the control group was superior to that of the C and D _ 1 groups, and the postoperative analgesia effect was more satisfactory. But the postoperative waking time and extubation time of D3 group were significantly longer than those of the other three groups, and the sedation depth of D3 group was significantly higher than that of the other three groups. The score of cough and restlessness in D3 group was significantly lower than that in C group and D1 group. Conclusion: preoperative intravenous dizosin 0.2mg/kg preemptive analgesia is effective for postoperative VAS analgesia in patients undergoing gynecological laparoscopic surgery during the recovery period. The effect of VAS system is satisfactory and does not affect the patient's waking time and extubation time. The postoperative analgesia effect is accurate. The incidence of adverse reactions was low.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R614

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