| Objective: To investigate the efficacy and safety of dezocine onpostoperative emergence agitation in elderly patients undergoing totalintravenous anesthesia.Background: With the advent of population aging society, elderlypatientsrequired surgical treatment increased every year. The increasedelderly patients become a major challenge for anesthesiologist. Because ofthe decline of nerve function in some elderly patients, the recovery fromanesthesia response is difficult. Meanwhile, most patients sufferfromcardiovascular system diseases, the instability in recovery period willcause adverse consequences. Patients under general anesthesia emergenceagitation (EA, emergence agitation) is a problem frequently encounteredin clinical anesthesia, which may cause patients many complications.EAmay cause the management of postoperative anesthesia patients manyinconvenience. EA may lead patients to increased heart rate, bloodpressure, heart failure and other serious adverse consequences. Therefore,to maintain elderly patients is critical to the stability of the emergenceanesthesia. Studies have shown that the cause EA occurred mainly due tothe pain. The dezocine is a mixed-opioid receptor antagonist analgesics, which has less side effects than traditional opioid analgesics, and is widelyused in clinical.Methods: Patients undergoing abdominal surgery were selected randomlyin Second Clinical Hospital of Jilin University during October2012toJanuary2013. Inclusion criteria:(1) aged60to80years;â‘¡The weight40to80kg;(3) not limited to sex;â‘£ASA (AmericanSociety ofAnesthesiologists) grade â… ~III. Exclusion criteria:â‘ past preoperativemyocardial ischemic disorder;â‘¡severe hepatic, renal damage;â‘¢opioiddrug addiction history or a history of allergies;â‘£behavioral disorders ormental abnormalities;⑤abnormal anesthetic history;â‘¥intraoperativeaccidents condition (such as intraoperative massive blood loss, etc.). Theultimately selected medical records of60cases, the random numbermethod patients were divided into3groups, the surgery before60minintravenous dezocine group (A, n=20);20min before surgery intravenousthe dezocine group (B group,20patients); controlled group, theperioperative no use to dezocine (C group, n=20). Patients of the threegroups received the same preoperative preparation, anesthesiainductionand anesthesia maintainness. Entering the operating room,patients werecontinuously monitored with non-invasive blood pressure(NIBP), electrocardiogram (ECG), heart rate (HR), pulse oxygensaturation (SpO2), end-tidal carbon dioxide partial pressure (PETCO2)and bispectral index (BIS) central venous pressure (CVP). Records and observation of the general information of the three groups of patients wereconducted, along with the patients basic vital signs: HR, SBP, DBP, SpO2parameters; awakening time; postoperative agitation score, sedation score(Ramsay score), complained of pain scores (VRS) atreconsciousness,extubation,5min after extubation,10min and20min after extubation.Postoperative nausea, vomiting, itchy skin will also berecorded forstatistical analysis between groups.Results:1General information and vital signs: three groups showed nosignificant differences.2Wake up time: Group A and C have significant difference comparedto Group B. There is great difference between Group A and Group C.3postoperative emergence agitation score: Groups A and Bhavesignificant difference compared to Group C.4Sedation score: Group A and B have significant differencecompared to Group C. There is great difference between Group A andGroup B.5Adverse reactions: three groups showed no significant differences.Conclusion:â‘ Intravenous injection of dezocine60min or20min before the endof surgery have some preventive effect on emergence agitation in elderlyanesthesia. â‘¡I ntravenous injection of dezocine20min before the end ofsurgery may cause prolonged anesthesia sedation.Dezocine cause little postoperative incidence of adverse reactions, whichcan be safely used in the prevention and treatment of emergenceagitationin elderly patients. |
