喷他佐辛对颅脑外科手术患者的麻醉效果及导尿管相关膀胱刺激征的影响

Effect of pentazocine on anesthesia and incidence of catheter-related bladder discomfort in patients undergoing craniocerebral surgery

摘要:

目的 探讨喷他佐辛对颅脑外科手术患者的麻醉效果及对导尿管相关膀胱刺激征（CRBD）的影响。方法 选取2021年1月—2022年12月在贵州省黔东南州人民医院行颅脑外科手术的患者120例。采用随机数字表法将患者随机分为观察组和对照组，每组60例。所有患者行全身麻醉，观察组术毕给予喷他佐辛，对照组给予等量生理盐水。观察两组患者拔管前（T₁）、拔管即刻（T₂）、拔管后5 min（T₃）、拔管后10 min（T₄）的平均动脉压（MAP）、收缩压（SBP）、舒张压（DBP）、心率（HR）和氧饱和度（SpO₂），分析两组苏醒期Ramsay评分、躁动评分、CRBD的变化。结果 观察组与对照组T₁、T₂、T₃、T₄时的MAP、SBP、DBP、HR和SpO₂比较，结果 ①不同时间点MAP、SBP、DBP、HR和SpO₂比较，差异均无统计学意义（P >0.05）；②观察组与对照组MAP、SBP、DBP、HR和SpO₂比较，差异均无统计学意义（P >0.05）；③观察组和对照组MAP、SBP、DBP、HR和SpO₂的变化趋势比较，差异均无统计学意义（P >0.05）。观察组苏醒期Ramsay评分2～4分和躁动评分0、1分占比高于对照组（P <0.05）。观察组CRBD发生率低于对照组（P <0.05），且严重程度轻于对照组（P <0.05）。观察组头痛发生率低于对照组（P <0.05）。结论 喷他佐辛在颅脑外科手术中有较好镇静作用，可减少CRBD的发生，且不良反应少。

Abstract:

Objective To explore the effect of pentazocine on anesthesia and incidence of catheter-related bladder discomfort (CRBD) in patients undergoing craniocerebral surgery.Methods A total of 120 patients undergoing craniocerebral surgery in our hospital from January 2021 to December 2022 were selected. They were divided into the observation group and the control group by the random number table method, with 60 cases in each group. All patients underwent general anesthesia, and the observation group was given pentazocine after the surgery while the control group was given the same amount of normal saline. The mean arterial pressure (MAP), systolic pressure (SBP), diastolic pressure (DBP), heart rate (HR) and oxygen saturation (SpO₂) before extubation (T₁), immediately after extubation (T₂), 5 minutes after extubation (T₃) and 10 minutes after extubation (T₄) were observed. The differences in the Ramsay Sedation Scale score and the agitation score during early recovery from general anesthesia and the incidence of CRBD between the two groups were analyzed.Results MAP, SBP, DBP, HR, and SpO₂ at T₁, T₂, T₃ and T₄ in the observation group and the control group were compared, and the results revealed that there was no significant difference in these indicators among the time points (P > 0.05) or between the observation group and the control group (P > 0.05). The change trends of MAP, SBP, DBP, HR, and SpO₂ were also not different between the two groups (P > 0.05). The percentages of patients with 2 to 4 points of the Ramsay Sedation Scale and 0 to 1 point of the agitation score during early recovery from general anesthesia in the observation group were significantly higher than those in the control group (P < 0.05). The incidence of CRBD in the observation group was lower than that in the control group (P < 0.05), and the severity of CRBD in the observation group was lower than that in the control group (P < 0.05). The incidence of headache in the observation group was significantly lower than that in the control group (P < 0.05).Conclusions Pentazocine is effective for sedation during the craniocerebral surgery and reduces the incidence of CRBD with few adverse reactions.