中文摘要：

目的：探讨地佐辛复合瑞芬太尼用于甲状腺术麻醉对苏醒质量的影响。方法行全麻下甲状腺手术患者65例，随机分为地佐辛＋瑞芬太尼组（D组）30例和瑞芬太尼组（R组）35例，R组采用瑞芬太尼＋丙泊酚维持麻醉，D组采用地佐辛＋瑞芬太尼＋丙泊酚维持麻醉，比较两组围拔管期的血流动力学变化、副反应、拔管以后的镇静指标、苏醒质量以及各个时点伤口疼痛程度等指标；在手术后24 h随访患者术中知晓及回忆围拔管期的不良反应。结果与R组相比，D组副反应明显下降，患者在拔管后血流动力学比较稳定，躁动和寒战的发生率显著下降，Ramsay评分为1级的病例数明显降低，在拔管后每个时点的VAS评分均明显降低（P＜0．05或P＜0．01），而两组的呼吸恢复时间、睁眼时间和拔管时间没有显著差异（P＞0．05）。结论甲状腺全麻手术围拔管期，瑞芬太尼复合地佐辛与单独使用瑞芬太尼相比，可提供更加平稳的血流动力学环境，减少苏醒阶段疼痛和躁动的发生率，且不会延长患者的苏醒和拔管时间。

英文摘要：

Objective To explore the effect of dezocine with remifentanil on the quality of recovery from anesthesia for thyroid operation.Methods Total 65 patients to receive thyroid operation under general anesthesia were randomly divided into dezocine ＋remifentanil group （group D, n=35） and remifentanil group （group R, n=35）.Remifentanil ＋propofol were administered to the patients in group R to maintain anesthesia , while dezocine ＋remifentanil ＋propofol were administered to the patients in group D to maintain anesthesia .The hemodynamic environment and side reaction during extubation , sedation index and awakening quality after extubation , and the wound pain degree at every time point etc .were compared;follow-up was made within 24 hours after the operation to know what the patients knew during the operation and any side reaction during the extubation .Results Compared with group R , the side reactions in group D decreased significantly;after extubation , the hemodynamic environment of the patients in group D was more stable, the incidence of restlessness and chills decreased significantly , the number of patients with Ramsay scores at level 1 decreased significantly, and the VAS scores at every time point after the extubation also decreased significantly （P〈0.05 or P〈0.01）, while the breathing recovery time, eye opening time and extubation time in two groups had no significant difference （P〉0.05）.Conclusion During the extubation of thyroid operation under general anesthesia , compared with only use of remifentanil , combined use of remifentanil with dezocine can provide a more stable hemodynamic environment for the patients , reduce incidence of restlessness and pain during the recovery from anesthesia , and will not extend the patients＇recovery and extubation time .