地佐辛联合罗哌卡因浸润麻醉对鼓室成形术老年患者的镇静镇痛作用

Effects of dezocine combined with ropivacaine infiltration anesthesia on sedation and analgesia after tympanoplasty in elderly patients

摘要

目的 探究地佐辛联合罗哌卡因浸润麻醉对鼓室成形术老年患者的镇静镇痛作用。方法 选取2021年1月—2022年1月首都医科大学附属北京同仁医院耳鼻喉科择期全麻下行单侧鼓室成形+听骨链重建术的90例老年患者作为研究对象, 按照随机数字表法分为观察组 (地佐辛联合罗哌卡因浸润麻醉组) 和对照组 (地佐辛注射组), 各45例。比较两组术中瑞芬太尼用量, 术毕出麻醉恢复室即刻以及术后6 h、12 h、24 h术侧耳痛视觉模拟评分 (VAS) 和Ramsay镇静评分 (RSS) 以及术后不良反应的发生情况。结果 观察组瑞芬太尼用量少于对照组, 切皮即刻的血压低于对照组, 手术时间长于对照组, 差异均有统计学意义 (P<0.05); 手术后恶心呕吐不良反应发生情况比较, 差异无统计学意义 (P>0.05)。两组出麻醉恢复室即刻的VAS比较, 差异无统计学意义 (P>0.05), 观察组术后6 h、12 h及24 h的VAS均低于对照组 (P<0.05)。两组出麻醉恢复室即刻的RSS比较, 差异无统计学意义 (P>0.05), 观察组术后6 h、12 h及24 h的RSS均高于对照组 (P<0.05)。结论 地佐辛联合罗哌卡因浸润麻醉的应用对鼓室成形术老年患者术后镇静镇痛作用良好, 且无明显不良反应。

Abstract

Objective To explore the sedative and analgesia effects of dezocine combined with ropivacaine infiltration anesthesia in elderly patients undergoing tympanoplasty. Methods A total of 90 elderly patients who underwent elective unilateral tympanoplasty + ossicular chain reconstruction under general anesthesia in the Department of Otorhinolaryngology, Beijing Tongren Hospital Affiliated to Capital Medical University from January 2021 to January 2022 were selected as the research objects. They were divided into an observation group (dezocine combined with ropivacaine infiltration anesthesia group) and a control group (dezocine injection group) according to the random number table method, with 45 cases in each group. The dosage of remifentanil during operation, the visual analog scale (VAS) for operative ear pain, Ramsay Sedation Scale (RSS) immediately after leaving the post-anesthesia care unit (PACU), and at 6 h, 12 h, and 24 h after operation, as well as postoperative adverse reactions were compared between the two groups. Results The dosage of remifentanil in the observation group was less than that in the control group, the blood pressure immediately after skin incision was lower than that in the control group, and the operation time was longer than that in the control group, with statistically significant differences (P<0.05). There was no statistically significant difference in the incidence of postoperative nausea and vomiting between the two groups (P>0.05). There was no statistically significant difference in VAS between the two groups immediately after leaving the PACU (P>0.05), while the VAS of the observation group at 6 h, 12 h, and 24 h after operation was lower than that of the control group (P<0.05). There was no statistically significant difference in RSS between the two groups immediately after leaving the PACU (P>0.05), and the RSS of the observation group at 6 h, 12 h, and 24 h after operation was higher than that of the control group (P<0.05). Conclusion Dezocine combined with ropivacaine infiltration anesthesia exerts good sedative and analgesia effects in elderly patients after tympanoplasty, without obvious adverse reactions.

关键词

地佐辛 / 罗哌卡因 / 浸润麻醉 / 鼓室成形术 / 镇静 / 镇痛

Key words

Dezocine / Ropivacaine / Infiltration anesthesia / Tympanoplasty / Sedation / Analgesia

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基金资助

^*北京市属医院科研培育计划(PX2022004)