地佐辛辅助腰硬联合麻醉时对二氧化碳通气反应的影响(1)
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[摘要] 目的：观察地佐辛辅助腰硬联合麻醉对二氧化碳通气反应的影响。方法：选20例择期腹部手术患者，于腰硬联合麻醉前后及辅助静注地佐辛5 mg后5 min分别观测患者的呼吸频率(RR)、潮气量(VT)、脉搏氧饱和度(SpO2)，呼气末二氧化碳分压，并记录地佐辛使用前后5 min患者吸入二氧化碳的通气反应。结果：在腰硬联合麻醉及地佐辛使用前后，患者的SpO2、RR及呼气末二氧化碳分压均无明显改变。潮气量在腰硬联合麻醉前后无明显改变，但在地佐辛使用后5 min明显下降(P<0.01)。二氧化碳通气反应曲线的斜率未见明显改变。结论：地佐辛辅助腰硬联合麻醉对患者的VT有一定影响，但对呼吸中枢的抑制作用较轻。
[关键词] 地佐辛；腰硬联合麻醉；二氧化碳；通气反应
[中图分类号] R618.4 [文献标识码] C [文章编号] 1674-4721(2011)12(b)-090-02
Effects of Dezocine on ventilatory response to carbon dioxide in combined-epidural labor analgesia
YANG Dubiao
Shangqiu First People's Hospital, Henan Province, Shangqiu 476100, China
[Abstract] Objective: To investigate the effect of Dezocine on ventilatory response to carbon dioxide in combined spinal epidural analgesia (CSEA). Methods: Twenty patients undergoing abdominal surgery were given Dezocine 5 mg, to observe the patient's respiratory frequency (RR), tidal volume-the (VT), pulse oxygen saturation (SpO2), breathe out carbon dioxide points at the end of the pressure before and after CSEA and 5 minutes after Dezocine injection. And to record ventilatory response of carbon dioxide in 5 min before and after Dezocine injection. Results: End-tidal concentration of CO2, RR and pulse oxygen saturation did not change significantly after spinal block and Dezocine. There was no significant change in VT after spinal block compared with the baseline value but VT decreased significantly after Dezocine (P<0.01). There was no significant change in the slope of CO2 ventilatory response curve before and after Dezocine but VT at different end-tidal concentration of CO2 decreased significantly 5 min after Dezocine. Conclusion: Dezocine given after spinal block decreases VT but depression of respiratory center is slight and lasts for short period of time.
[Key words] Dezocine Injection; Combined spinal epidural anesthesia; Carbon dioxide; Ventilatory response
腰硬联合麻醉是我国目前最常用的麻醉方法之一，但存在患者术中精神紧张和内脏牵拉反应等缺点，故常需要辅助使用镇痛镇静药物。地佐辛是是一种强效阿片受体激动剂，并且具有明确的镇静作用[1]，可用来辅助椎管内麻醉镇痛镇静，本研究拟评价其辅助椎管内麻醉时对呼吸中枢的抑制作用。
1 资料与方法
1.1 一般资料 ......
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