微创医学

目的对比观察地佐辛与舒芬太尼对老年胸腔镜肺叶切除术患者围拔管期反应的影响。方法 60例胸腔镜肺叶切除术老年患者随机分为D1、D2和SF三组,手术结束前15 min,D1组和D2组分别静脉注射地佐辛0.1 mg/kg和0.15 mg/kg,SF组静脉注射舒芬太尼0.1μg/kg。在围拔管期,观察血压、心率、睁眼时间、拔管时间和定向力恢复时间;记录拔管后疼痛、躁动评分、需要再次镇痛的例数、不良反应和动脉血气分析等。结果三组患者在拔管时血流动力学、烦躁评分、疼痛评分无明显差异(P>0.05);与D1组相比,SF组患者拔管后SpO2明显降低(P<0.05),三组拔管后PaO2、PaCO2无明显差异(P>0.05)。结论地佐辛抑制老年胸腔镜肺叶切除术患者围拔管期的不良反应效果显著,呼吸抑制及过度镇静的风险小。

Objective To compare the effects of dezocine and sufentanil on the reaction during the peri-extubation period in the elderly undergoing thoracoscopi procedures． Method Sixty elderly patients scheduled for thoracoscopic lobectomy were randomized into group D1，D2 or SF． At 15 min before the end of procedure，intravenous dezocine 0． 1 mg /kg，0． 15 mg /kg or sufentanil 0． 1μg /kg was given in group D1，D2 or SF，respectively． Around the extubation period，blood pressure，heart rate，eyes open time，extubation time， orientation recovery time were observed． After extubation，pain，restlessness，analgesia supplement，side effects and blood gas analyses were recorded． Results At the time of extubation，there was no any significant difference in hemodynamics，pain score，or restlessness score among the three groups ( P ＞ 0． 05) ． SpO2 of group D1 was significantly higher than that of group SF after extubation ( P ＜ 0． 05 ) ． There was no any significant difference in PaO2 or PaCO2 among the three groups ( P ＞ 0． 05) ． Conclusion Dezocine can significantly constrain the adverse reactions in elderly patients undergoing thoracoscopic procedures during the peri-extubation period，with low risk of respiratory depression or excessive sedation．