Adjuvant Analgesics Dezocine Regulates Bidirectional Awakening Quality Of Geneial Anesthesia In Perioperative Treatment For Gynecological Surgery

Objective To evaluate the awakening quality of general anesthesia treated with adjuvant analgesics dezocine in different time point undergoing gynecological surgery. Methods 90 patients undergoing gynecologic surgery, ASA physical status I–II, were randomized into three equally sized groups(n = 30) : Group A was assigned to give intravenous dezocine 0.1 mg/kg 10 min before gynecological operation. Group B was injected 0.1mg/kg dezocine 30 min before the end of surgery. And Group C was injected equal volume of 0.9 % saline as placebo. Anesthesia management: for anesthesia induction, 0.05 mg/kg midazolam, 0.3 mg/kg etomidate, 0.5 ug/kg sufentanil, 0.1 mg/kg infusion of vecuronium closed-loop induced. Unified accurate anesthesia management in perioperative period, propofol target controlled infusion as 2.0 to 2.5 ug/ml with the BIS monitoring at 40-50, sevoflurane inhalation monitoring at 0.3-0.5MAC, vecuronium closed-loop infusion to maintain muscle relaxant(added conditions: T1 > 7%), 0.2 ug/kg/h of sufentanil continuous pump, stop drug 30 min before the end of surgery. The end of the operation, BIS > 60, T1 > 90% move to PACU, related indicators during the PACU were observed(dwell time, extubation time, waking hours, VAS score, associated complications). After 1 h, 2 h, 6 h, 24 h follow-up, Patients’ pain VAS score were assessed together with the opioid related adverse reactions such as nausea, vomiting, aeration time and the patients’ overall satisfaction. Results Patients’ age, body mass index(BMI), the operative time, anesthesia time and the extubation time were no statistical difference among three groups. Compared with awakening quality of general anesthesia dwelling in the PACU, group B is better than group A and group C. Awaking-time: Group A(12.6±2.3) min, Group B(7.7±1.4) min, Group C(13.4±2.5) min, the awaking-time of group B is significantly shorter than Group A and Group C(P < 0.05). The incidence of respiratory depression after extubation were significantly higher in Group A(3/30, 10 %) than in Group B(0/30, 0 %) or Group C(0/30, 0 %)( P< 0.05). The pain VAS score at 2 h of postoperative: Group A(0.50±0.73), Group B(0.33±0.48), Group C(1.36±0.72), the VAS score of Group A and Group B are better than group C(P < 0.05), no statistical difference between group A and B. Postoperative delirium: There are 2 patients with delirium in Group C(2/30, 6.7%), compared with no delirium in Group A(0/30) and Group B(0/30)(P<0.05). The incidence of nausea and vomiting in group A and group B are better than group C(P<0.05). All patients showed stable cardiovascular profiles. Conclusion The results demonstrate that adjuvant analgesics Dezocine can improve the quality of patient awake in perioperative;Intravenous dezocine 0.1 mg/kg 30 min before the end of surgery is effective in improving the awakening quality of patients with general anesthesia and suppressing the significant side-effects; However, infusion dezocine 0.1 mg/kg 10 min before gynecological operation may increase the respiratory depression incidents of patients in PACU.