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1、疼痛治疗与研究【摘要】目的探讨地佐辛预防瑞芬太尼全麻痛觉过敏及苏醒期躁动中的效果及安全性方法将100例ASAI〜II级择期腹腔镜胆囊切除术患者随机分为D、Di、D2、F四组各25例，均采用静脉复合麻醉，术屮靶控输注瑞芬太尼，持续静脉泵注异丙酚，间断给予顺阿曲库鞍维持麻醉。关腹前30min分别肌肉注射地佐辛D组：0.1mg/kg、D.组：0.2mg/kg>D2组：0.3mg/kg,对照组F组给予芬太尼lug/kg。记录各组苏醒时间、拔管时间、拔管时的血流动力学指标、拔管后的VAS评分、SAS评分以及BCS评分、拔管后苏醒室内恶心呕吐及烦躁等不良反应
2、。结果拔管时各组的血流动力学指标比较无统计学意义（P>0.05）；苏醒时间及拔管时间F组最长；苏醒后VAS评分D组最高，D］组、D?组与D组比较有统计学意义（PV0.05）,D］组与D?组比较无统计学意义（P>0.05）,F组苏醒后VAS评分最低；SAS评分D组最高，D2组最低，Di组、D2组与D组比较有统计学意义（P<0.05）；BCS评分Di组、D2组、F组与D组比较有统计学意义（P<0.05）。结论0.2mg/kg地佐辛于手术结束前30min分钟肌肉注射可安全有效减轻瑞芬太尼麻醉后痛觉过敏并可预防全麻苏醒期躁动。地佐辛；瑞芬太尼；痛觉过敏【
3、Abstract】ObjectiveToinvestigatetheeffectofdezocineonremifentanil-inducedhyperalgesiaandrestlessnesspostoperation.Methods100casesofupperLaparoscopiccholecystectomy,ASAI~IIclass,wererandomlydividedintofourgroups,usingintravenousanesthesiaplusintubation,intraoperativeremifentani
4、ltarget-controiledinfusion,continuousintravenousinjectionofpropofolandgivenintermittentvecuroniumtomaintainanesthesia.0」mg/kg(groupD,n=20),0.2mg/kg(groupD1,n=20),0.3mg/kg(groupD2,n=20)ofdezocineweregivenintramuscularbefore30minofabdominalclosure.ControlgroupFentanyl(groupF,n=
5、20).Recordsthetimeofrecoveryandextubation,hemodynamicparametersofextubationtime,theVASpainscoreandSASscoreandBCSscoreafterextubationandthetimeofrequirementsofanalgesiafromextubation,adversereactionswithnauseaandvomitinganddysthesiaafterextubation.ResultsTherewerenostatistical
6、significanceofhemodynamicparametersofextubation(P>0.05);Wakingtimeandextubated,thelongesttimegroupF;AwokeVASratinggroupDhighest,groupD【、D2andgroupDcomparisonwasstatisticallysignificant(PV0.05),groupcomparedwithD2wasnotstatisticallysignificant(P>0.05),groupFawokeVASscorelowest
7、;SASratinggroupDhighest,groupD2lowest,groupDi、D2andgroupDcomparisonwasstatisticallysignificant(P<0.05);BCSscoregroupD［、D2、FcomparedwithDgroupFwasstatisticallysignificant(P<0.05).Conclusion0.2mg/kgofdezocineintrmuscularinjectionbefore30minoftheendofsurgurycanbesafelyandeffecti
8、velyreducethehyperalgesiaandrestlessnessafterremifentanilanesthesia[
