| Backgrounds and ObjectivesDezocine appeared in the domestic market in2009, which is a new type of mixed opioid receptor agonist-antagonist. it is mainly excited κ receptors to produce analgesia and partially antagonize μ. receptor, because of this, it have minimal impact on the respiratory system. Compared with the pure opioid receptor agonists following are some differences:①analgesic potency is smaller;②the respiratory inhibition is relatively light;③does not produce euphoria;④rarely lead to dependency. Because of this characteristic, dezocine is widely used in clinical, such as painless abortion, preemptive analgesia and the acute and chronic pain.Endoscopic Retrograde Cholangio-Pancreatography(ERCP) as the gold standard for diagnosis of extrahepatic bile duct stones, the accuracy rate is more than90%. ERCP has become an important method for pancreaticobiliary duct diseases diagnosis and treatment. However, the operation-invasive stimulus bring discomfort to the patient, and even can cause severe cardiovascular complications.Ketamine is a phencyclidine class intravenous anesthetic, which has significant analgesic effect and negligible effect on respiration. Currently, ketamine and propofol for ERCP anesthesia are commonly used. Many scholars studied dezocine or small-dose ketamine combined with propofol for ERCP to find the effect of sedation and analgesic satisfied, respiratory and circulatory stable, low adverse events.This study compare the clinical efficiency of dezocine and ketamine combined with propofol for Anesthesia in ERCP to seek an ideal anesthesia program. So as to offer reference for dezocine used in minor surgery.Objects and MethodsSixty ASA I or II patients undergoing ERCP surgery from July to December,2011, aged30-89yr,who were randomly divided into two groups:dezocine combined with propofol (group D) and ketamine combined with propofol (group K). Method:In group D, Anesthesia was induded with dezocine5mg and propofol1.5mg·kg-1, maintained:dezocine1.0ug·kg-1·min-1and propofol3-5mg·kg·-h-1; In group K, Anesthesia was induded with ketamine0.5mg·kg-1and propofol1.5mg·kg-1, maintained:ketamine1.0mg·Kg-1·h-1and propofol3-5mg·Kg-1·h-1.Observe and record:1min before induction (To),5min after induction (T1), the time of entry (T2), surgery (recorded intraoperative any three times to take the mean)(T3), wakening (T4) at different time points HR, MAP, RR, SpO2, wakening time, and the incidence of adverse reactions:body movement, apnea, nausea and vomiting, dizziness. If body movement occurs, additional propofol is given by intravenous injection.SPSS13.0version was used for statistical analysis. Measurement data was signified by mean±standard deviation(x±s). Aanalysis of variance was used to compare the repeated measurement data within group. Count data using x2test. P <0.05was considered statistically significant difference.ResultsThere were no significant difference in age, weight and operation time.The HR at T1in group K was higher than that in group D (P<0.05). The MAP and the HR at T2, T3, T4in group K were slightly higher than that in group D, but there were no significant difference between two groups(P>0.05). The awakening time in group D was shorter compared with that of group K (P<0.05). The incidence of adverse reactions (body movement and dizziness) of group D was lower than group K (P<0.05).Conclusions The anesthhesia effect of dezocine combined with propofol in ERCP is satisfactory, compared with ketamine combined with propofol,which shorten the awakening time, decreased adverse reactions. |
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