地佐辛用于预防全麻苏醒期躁动的临床应用
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地佐辛预防全麻苏醒期患者躁动的临床观察【摘要】目的观察地佐辛在预防和减少全麻术后躁动方面的有效性。
方法随机选择全麻手术患者60例,随机均分为A(实验)组、B(对照)组,每组各30例。
于估计手术缝合皮肤结束前约30 min时A组给予静推地佐辛0.1 mg/kg,B组以同样速度静脉注射生理盐水。
按照Riker 镇静和躁动评分标准给患者在缝合皮肤结束至拔除气管导管期间进行评分。
结果A组躁动发生率明显小于B组,不良反应发生率无明显变化。
结论地佐辛用于全麻患者,可有效减少全麻患者苏醒期躁动的发生。
【关键词】地佐辛;全麻患者;躁动全麻患者苏醒期躁动是全麻术后常见的并发症,有效减少全麻苏醒期患者躁动,可以降低麻醉及手术相关并发症的发生率。
本研究观察了地佐辛在预防和减少全麻苏醒期躁动方面的效果。
1 资料与方法1.1 一般资料随机选择全麻手术患者60例,年龄18~76岁,体质量45~85 kg,ASAⅠ~Ⅱ级,术前均无明显心、肺、肝肾等功能异常,无精神系统疾病病史,随机均分为A(实验)组和B(对照)组,各30例。
手术种类包括:甲状腺切除术、胆道手术、胃癌根治术、全子宫切除术、宫颈癌根治术等。
1.2 麻醉方法所有患者均术前留置导尿管,术前30 min给予苯巴比妥钠2 mg/kg及阿托品0.01 mg/kg肌肉注射,全麻诱导为咪唑安定0.04 mg/kg,芬太尼0.002 mg/kg,丙泊酚2 mg/kg,司可林2 mg/kg。
气管插管后给予异氟醚、丙泊酚、瑞芬太尼、阿曲库胺维持。
根据麻醉的需要调节瑞芬太尼和丙泊酚的剂量,严格控制肌松药用量。
患者自主呼吸恢复,潮气量达到7 ml/kg以上,有吞咽反射后拔除气管导管,必要时面罩给氧。
A组于估计手术缝合皮肤结束前约30 min 时静脉注射地佐辛0.1 mg/kg(生理盐水稀释到5 ml),B组于估计手术缝合皮肤结束前约30 min时以同样速度静脉注射生理盐水5 ml。
1.3 观察指标采用双盲法,以Riker 镇静和躁动评分评价两组患者在缝合皮肤结束至拔除气管导管期间的躁动情况。
地佐辛预防全身麻醉苏醒期患者导尿管源性躁动目的:观察地佐辛对全身麻醉苏醒期患者导尿管源性躁动的防治效果。
方法:100例全麻下骨科、普外科手术患者,随机分为两组,对照组和观察组各50例均在全麻诱导后行导尿术,比较两组患者在全身麻醉苏醒期因导尿管所致的躁动发生率。
结果:观察组与对照组比较,后者膀胱刺激发生率、躁动程度明显高于前者(P<0.01)。
结论:地佐辛能有效预防苏醒期导尿管源性躁动。
标签:全麻;镇痛;麻醉药;导尿管;躁动为了减轻术前置导尿管给患者带来疼痛、恐惧等不良刺激,本院选择在全麻诱导后再行导尿管置入术。
但此方法却明显增加患者在麻醉苏醒期躁动的发生,增加术后并发症的发生率[1]。
笔者用地佐辛治疗苏醒期躁动,报道如下:1 资料与方法1.1 一般资料选择2008年3月~2010年10月收治的100例患者,男73例,女27例,其中急诊手术29例,ASAⅠ~Ⅱ级,无严重心血管疾病,无肝肾功能不全,无中枢神经系统疾病及精神疾病,且要留导尿管在全麻下行普外科骨科手术的患者为研究对象。
1.2 方法所有患者均采用相同的麻醉方法,入室后开放静脉后监测呼吸循环。
芬太尼4 μg/kg,异丙酚1.5 mg/kg,司可林1.5 mg/kg 快诱导气管插管后机械通气,静吸复合维持麻醉,气管插管后行导尿术。
随机分为两组,各50例,尿道插入F16号Foley气囊导尿管。
手术结束前30 min,观察组静注5 mg地佐辛。
清醒拔管后,评估躁动程度。
无为患者安静合作;轻为被询问时主述不适但不伴有行为反应;中为频繁主动表示不适;重为频繁有行为反应,如四肢乱动,甚至要拔掉导尿管。
当出现重度躁动,需要给异丙酚0.5 mg/kg 治疗。
1.3 统计学处理采用SPSS 13.0进行统计学处理,计量数据采用均数±标准差(x±s)表示,导尿管脱出率的比较用χ2检验。
P<0.05为差异有统计学意义。
2 结果两组患者一般情况、手术时间和芬太尼用量的比较差异无统计学意义,均P>0.05。
地佐辛对减轻小儿耳鼻喉手术全身麻醉苏醒期躁动的作用摘要:目的:以耳鼻喉手术患儿作为研究对象,分析地佐辛对全身麻醉苏醒期躁动的预防性作用。
方法:采用随机抽样法,于我院2017年9月--2018年8月收治的耳鼻喉小儿患者中,随机抽取68例患者入组研究,分为地佐辛组和氯化钠溶液组,分别予以两组患者地佐辛和氯化钠溶液治疗。
结果:地佐辛组患者的麻醉时间、手术时间较长,拔管时间较短,且地佐辛组患者的苏醒期躁动评分较低。
结论:为了提升小儿麻醉苏醒期的安全性,应在耳鼻喉手术时,为患者静脉泵注地佐辛,形成临床疗效提升的保障。
关键词:地佐辛;耳鼻喉手术;麻醉苏醒Effect of Dezocine on Reducing Restlessness During General Anesthesia in Children Undergoing Ear,Nose and Throat Surgery[Abstract]Objective:To analyze the preventive effect of deszocine on restlessness during recovery from general anesthesia in children undergoing otolaryngological surgery. Methods:A total of 68 children with otorhinolaryngology admitted to our hospital from September 2017 to August 2018 were randomly selected and divided into two groups:dexoxine group and sodium chloride solution group. Results:The anesthesia time,operation time and extubation time were longer in the DZX group,and the restlessness score was lower in the DZX group. Conclusion:In order to improve the safety of pediatric anesthesia recovery,intravenous injection of dizocine should be used in otolaryngological surgery to ensure the improvement of clinical efficacy.[Key words] dezocine;otorhinolaryngology surgery;anesthesia recovery前言在耳鼻喉手术的麻醉苏醒期,患儿极容易出现躁动症状,导致行为与精神的分离。
地佐辛预防全身麻醉苏醒期患者躁动的临床观察【摘要】目的: 观察地佐辛预防全身麻醉苏醒期患者躁动的效果。
方法: 选取本院收治的78例ASAⅠ或Ⅱ级全身麻醉下行择期腹腔镜手术患者为研究对象,随机分为对照组与地佐辛组,每组39例。
患者手术结束前30min,地佐辛组静脉注射地佐辛5mg,对照组静脉注射等量的生理盐水。
观察两组患者躁动的发生情况,患者的呼吸恢复时间、睁眼时间以及拔管时间以及不良反应等。
结果:地佐辛组的躁动评分明显优于对照组,两组相比,差异有统计学意义(P<0.05)。
地佐辛组和对照组患者的呼吸恢复时间、睁眼时间以及拔管时间和不良反应发生率相比,差异无统计学意义。
结论:地佐辛可有效预防全身麻醉苏醒期躁动的发生,且安全可靠,值得临床推广。
【关键词】地佐辛;全身麻醉;苏醒期躁动【中图分类号】R614.2 【文献标识码】B 【文章编号】1003-5028(2015)6-0479-02Clinical Effect of Dezocine in Prevention of Restlessness during Anesthesia【Abstract】Objective:Observation of clinical effect of dezocine in prevention of restlessness during anesthesia. Methods:78 cases of ASAⅠor Ⅱ patients undergoing elective gynecological laparoscopy under sevoflurane general anesthesia were randomly divided into 2 groups with 39 cases each. Group Dezocine received dezocine 5 mg 30 min before the end of operation, Group Control received equal volume of normal saline. The occurrence of agitation was observed during waking-up period. Agitation scale; from the withdrawal to patients awake time; respiratory depression,nausea and vomiting dizziness,skin itching and other related adverse reaction after extubation were observed.Results:In group Dezocine, patients emergence agitation rate was significantly lower than that in group Control ( P<0.05), respiratory depression,constipation, itching and other adverse reactions between the 2 groups had no significant difference. Conclusion:Received iv dezocine before the end of operation can effectively prevent the occurrence of agitation during waking-up period of sevoflurane general anesthesia after gynecological laparoscopy.【Key words】Dezocine; General anesthesia; Postoperative agitation全身麻醉苏醒期患者躁动[1]是麻醉苏醒期的一种不适当行为,其具体表现为[2]语无伦次、肢体的无意识动作、哭喊或呻吟、无理性言语、妄想思维等,这些全身麻醉手术后的躁动挣扎、兴奋等现象增加了苏醒期的风险。
地佐辛预防腹腔镜胆囊切除术患者全麻苏醒期躁动临床成效分析伍江明张旭王东罗远国解放军第一八一医院麻醉科广西桂林541002【摘要】目的研究地佐辛预防腹腔镜胆囊切除术患者全麻苏醒期躁动的临床疗效,分析其临床价值。
方法随机将患者分为实验组和对照组,每组29例。
实验组给予地佐辛注射,对照组给予氯化钠溶液静脉滴注,然后分析两组患者的临床疗效。
结果对于拔管时间和全麻清醒时间两组无明显的差异,但平均动脉压、全麻苏醒期躁动发生率和拔管时的心率实验组相对于对照组较低,P<0.05。
结论地佐辛能有效地降低腹腔镜胆囊切除术患者全麻苏醒期躁动机率,值得临床推广。
【关键词】地佐辛;腹腔镜胆囊切除术;全麻苏醒期躁动;临床成效Clinical Effects of Dezocine on Prevention of Agitation during Revival Period in Full Anesthesia for Patients undergoing Laparoscopic Cholecystectomy Wu Jiangming, Zhang Xu, Wang Dong and Luo Yuanguo 【Abstract】Objective: To study the clinical effects of dezocine on prevention of agitation during revival period in full anesthesia after laparoscopic cholecystectomy and to analyze its clinical value. Method : Patients were randomly divided into two groups (n=29): experimental group and control group. The experimental group was injected dezocine, and the control group was injected sodium chloride solution through intravenous drip. Then we analyzed the clinical effects on patients of these two groups. Results:In terms of time to extubate and time to revive from full anesthesia, there are no obvious differences between these two groups. However, compared to the control group, the mean arterial pressure, the frequency of emergence agitation during revival period in full anesthesia and the heart rate during extubation are lower in the experimental group, P<0.05. Conclusion : Dezocine can reduce the frequency of emergence agitation during revival period in full anesthesia for patients undergoing laparoscopic cholecystectomy effectively, thus it is worthy of being widely applied in clinic practice.【Key words】Dezocine, laparoscopic cholecystectomy, agitation during revival period in full anesthesia, clinical effects于手术全麻复苏期,伴随患者体内麻醉药物的药效消除,患者的意识将会恢复,痛觉也将慢慢恢复进而出现不适感,所以形成全麻苏醒期躁动。