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1、西北國防醫(yī)學(xué)雜志2012年4月30日第33卷第2期MedJNDFNC，VOL．33，NO．2，April，2012123地佐辛與芬太尼用于硬膜外阻滯下闌尾切除術(shù)中抑制牽拉反應(yīng)的臨床觀察焦向陽，賀顯建，薛璋明，曾甜(解放軍323醫(yī)院麻醉科，陜西西安710054)[摘要]目的：觀察地佐辛與芬太尼在硬膜外阻滯下闌尾切除術(shù)中，抑制牽拉反應(yīng)的臨床效果和安全性。方法：選擇硬膜外下擬行闌尾切除術(shù)患者60例，隨機(jī)分為觀察組和對照組，每組各3O例。硬膜外阻滯效果確切后開始手術(shù)前，觀察組緩慢靜推地佐辛o．1mg／kg+托烷司瓊2mg，然后持續(xù)泵注地佐辛
2、1．5～2txg／(kg·min)至關(guān)腹。對照組緩慢靜推芬太尼1kg+托烷司瓊2mg，然后持續(xù)泵注芬太尼0．2—0．3g／(kg·min)至關(guān)腹。分別于手術(shù)前、切皮時、切開腹膜時、牽拉闌尾時、手術(shù)結(jié)束時監(jiān)測患者SBP、DBP、HR、SpO的變化，并對內(nèi)臟牽拉反應(yīng)狀況進(jìn)行評估。結(jié)果：切開腹膜時、牽拉闌尾時，觀察組與對照組比較差異無統(tǒng)計學(xué)意義(P>0．05)。結(jié)論：地佐辛與芬太尼在硬膜外阻滯下闌尾切除術(shù)中，都具有良好的抑制牽拉反應(yīng)作用；地佐辛安全性更高。[關(guān)鍵詞]麻醉學(xué)；地佐辛；芬太尼；闌尾切除術(shù)[中圖分類號]R614．42[文獻(xiàn)標(biāo)識碼
3、]A[文章編號]1007—8622(2012)02—0123—02InhibitoryeffectofdezocineandfentanylonvisceraltractionreactionduringappendectomyunderepiduralanesthesiaJIAOXiang—yang，HEXian—jian，XUEZhang—ming，eta1．(DepartmentofAnesthesiology，the323HospitalofPLA，Xihn710054，China)[Abstract]Objective：T
4、ostudytheeffectandsafetyofdezocineandfentanylforinhibitingthevisceraltractionreactionduringappendectomyunderepiduralanesthesia．Methods：Sixtypatientsundergoingappendectomyunderepiduralanesthesiawererandomlydividedintotheobservationgroup(n=30)andthecontrolgroup(n=30)．Aft
5、erepiduralanesthesia，thepatientsinobservationgroupwereslowlygivendezocine(0．1mg／kg)andtropise—tron2mgbyintravenousinjection，thengivencontinuallydezocine1．5—2~xg／kg／minbypumptilltheendofthesurgery．Thepatientsincontrolgroupwereslowlygivenfentanyl1kgandtropisetron2mg，then
6、givendezocine0．2—0．3g／kg／mincontinuallybypumptilltheendofthesurgery．ThevitalsignsincludingSBP，DBP，HRandSpO2wererecordedbeforeoperation，atthetimepointsofcuttingtheskin，openingtheperitonealcavityandpullingappendix，andattheendofoperation．Thevisceraltractionreactionwaseval
7、uatedduringoperation．Results：Atthetimepointsofopeningtheperitonealcavityandpullingappendix，therewasnosignificantdifferencebetweentheobservationgroupandthecontrolgroup(P>0．05)．Conclusion：Bothdezocineandfentanylaresig-nificantlyeffectiveforinhibitingthevisceraltractionre
8、actionduringappendectomyunderepiduralanesthesia，anddezocinemaybemoresafeforit．[Keywords]Anesthesiology；Dezocine；Fenta
