Effects of ropivacaine infiltration combined with dezocine on agitation during recovery from general anesthesia in patients undergoing cerebral surgery

Abstract

Objective To investigate the effects of ropivacaine infiltration combined with dezocine on the agitation during recovery from general anesthesia in the patients undergoing cerebral surgery. Methods Sixty patients of both sexes, aged 18-64 yr, of ASA physical status Ⅰ or Ⅱ, undergoing elective neurosurgery under general anesthesia, were randomly divided into 4 groups (n=15 each) using a random number table: control group (group C), ropivacaine group (group R), dezocine group (group D), and ropivacaine + dezocine group (group RD). Group C received local infiltration with normal saline 20 ml at 10 min before skin incision, and normal saline 2 ml was injected intravenously at 30 min before the end of operation. The patients received local infiltration with 0.5% ropivacaine 20 ml at 10 min before skin incision, and normal saline 2 ml was injected intravenously at 30 min before the end of operation in group R.Group D received local infiltration with normal saline 20 ml at 10 min before skin incision, and dezocine 10 mg was injected intravenously at 30 min before the end of operation.The patients received local infiltration with 0.5% ropivacaine 20 ml at 10 min before skin incision, and dezocine 10 mg was injected intravenously at 30 min before the end of operation in group RD.The time for recovery from anesthesia, extubation time, and development of agitation after extubation in PACU were recorded.Agitation was assessed and scored.Ramsay sedation score and VAS score were recorded immediately after extubation.The development of cardiovascular events and respiratory depression was recorded within 10 min after extubation.Before induction of anesthesia (T0), at the end of surgery (T1) and immediately after extubation (T2), blood samples were collected from the dorsal artery of foot for deter mination of the levels of blood glucose, plasma cortisone, epinephrine and norepinephrine. Results Compared with group C, the agitation score, incidence of agitation, VAS score, and incidence of postoperative hypertension were significantly decreased in R, D and RD groups, especially in R and D groups.The time for recovery from anesthesia and time for extubation were significantly shorter in R and RD groups than in group C. Ramsay sedation scores were significantly higher at the onset of extubation in R, D and RD groups than in group C. Ramsay sedation scores were significantly higher in D and RD groups than in group R. Compared with group C, the levels of blood glucose, plasma cortisone, epinephrine and norepinephrine were significantly decreased in R, D and RD groups, especially in group RD. Conclusion Ropivacaine infiltration combined with dezocine can reduce the agitation during recovery from general anesthesia in the patients undergoing cerebral surgery. Key words: Analgesics, opioid; Amides; Anesthesia, local; Agitation