摘要
目的 观察纳美芬不同给药时机对全麻下腹腔镜全子宫切除术后苏醒期间躁动的影响.方法 选择90例按美国麻醉医师协会（American Society of Anesthesiologists ASA）1～2级需要在全麻下行腹腔镜全子宫切除术的患者,随机分为三组,每组30例,分别在麻醉停药前5min（A组）,麻醉停药时（B组）和麻醉停药后5min（C组）静脉注入纳美芬0.25μg/kg.三组麻醉诱导及麻醉维持方法均相同.分别纪录麻醉维持时间、呼吸恢复时间、拔气管导管时间、拔管10min后的呼吸次数、拔管时镇静-躁动（RASS）评分及拔管后10min视觉模拟评分（VAS）.结果 三组患者麻醉维持时间差异均无显著性（P＞0.05）.A组与B组之间呼吸恢复时间、拔管时间和拔管后10min呼吸次数（次/分）差异均无显著性（P＞0.05）,A组和B组与C组之间呼吸恢复时间、拔管时间和拔管后10min呼吸次数（次/分）差异均有显著性（P＜0.05）,A组和B组比C组促进呼吸恢复的效果更明显;B组和C组与A组之间镇静—躁动评分和疼痛程度评分均差异有显著性（P＜0.05）,B组和C组比A组预防躁动和减轻术后10min疼痛效果更好.结论 全麻麻醉停药时静脉注入小剂量纳美芬,能够有效减少腹腔镜全子宫切除术后全麻苏醒期躁动的发生,并能促进呼吸的恢复.
Objective To observe the effect of nalmefene at different intravenous injection time to prevent the emergence agitation （EA） during recovery period from general anesthesia in total laparoscopic hysterectomy （TLH）.Methods 90 patients of ASA 1～2 undergoing the general anesthesia in the TLH were divided into three groups randomly.Group A（n=30） were injected nalmefene with 0.25μg/kg before the discontinuation of anesthetic for 5min.Group B （n=30） were injected nalmefene with 0.25μg/kg at the discontinuation of anesthetic.Group C（n =30） were injected nalmefene with 0.25μg/kg after the discontinuation of anesthetic for 5min.The time of anesthetic maintainence,the recovery time of the autonomous respiration,the extubation time,the respiration rate after the extubation 10min,Richmond Agitation-Sedation Scale （RASS） at the extubation and the Visual Analogue Scule （VAS） after the extubation 10min were observed Results No significantly differences of the anesthetic maintainence time were found （all P〉0.05）among the three groups.There were no obvious differences of the recovery time of the autonomous respiration and the extubation time and the respiration rate after the extubation 10min in group A and group B （P〉0.05）.The recovery time of the autonomous respiration and the extubation time and the respiration rate after the extubation l0min were obviously different among the three groups（all P〈0.05）,which in group A and group B were much shorter than group C.The RASS scores at the extubation and the VAS scores after the extubation 10min were obviously different among the three groups （all P〈0.05）,which in group B and group C were much better than group A.Conclusion To intravenous inject the nalmefene at the discontinuation of anesthetic can effectively decrease the EA during recovery period from general anesthesia and promote the recovery of respiration.
出处
《西部医学》
2014年第10期1328-1331,共4页
Medical Journal of West China
关键词
纳美芬
不同给药时机
腹腔镜下全子宫切除术
苏醒期躁动
Nalmefene
Different intravenous injection time
Total laparoscopic hysterectomy
Emergence agitation
