摘要
目的探讨羟考酮用于老年腹腔镜胆囊切除术麻醉诱导的适宜剂量。方法择期全麻下拟行腹腔镜胆囊手术的老年患者60例,性别不限,年龄60~74岁,体质量46~76 kg,ASA分级Ⅰ或Ⅱ级,采用随机数字表法分为A、B、C组(n=20)。麻醉诱导时A、B、C组分别予羟考酮0.2、0.25和0.3 mg·kg^(-1),iv;所有患者均予异丙酚1.5 mg·kg^(-1)和顺苯磺酸阿曲库铵0.15 mg·kg-1,iv。之后给予气管插管机械通气。记录每组患者的手术时间、麻醉苏醒时间、麻醉诱导前(T0)、气管插管前即刻(T_1)、气管插管后即刻(T_2)、手术开始即刻(T_3)、手术结束即刻(T_4)和拔除气管导管前即刻(T5)时的平均动脉压(MAP)和心率(HR),每组患者于手术后采用视觉模拟评分(VAS)法进行疼痛评分。结果与T_0时比较,A组的T_2、T_3和T_5时的MAP和HR升高(P<0.05),T_1和T_4的MAP降低(P<0.05);与A组比较,B组和C组的T_2、T_3和T_5时的MAP和HR更低(P<0.05),VAS也更低(P<0.05),而B组和C组之间差异均无统计学意义(P>0.05);A组和B组苏醒时间均较C组缩短(P<0.05),而A组和B组之间比较差异无统计学意义(P>0.05)。结论羟考酮用于老年患者腹腔镜胆囊切除术麻醉诱导的适宜剂量为0.25 mg·kg^(-1)。
AIM To discuss the optimum dose of oxycodone for anesthesia induction in elderly patients with laparoscopic cholecystectomy. METHODS Totally 60 elderly patients, no limit on the gender, aged 60 - 74 years, body mass 46 -76 kg,with American Society of Anesthesiologists physical status I or lI , were enrolled. The patients scheduled for laparoscopic cholecystectomy were randomly divided into 3 different doses of oxycodone groups（ n = 20 each）. Anesthesia induction （groups A, B, C ） was induced with oxycodone 0.20,0.25 and 0.30 mg·kg^-1, iv, respectively, and propofol 1.5 mg·kg^-1 and cisatracurium besilate 0.15 mg·kg^-1 ,iv. The patients were tracheally intubated and mechanically ventilated. The operation time, anesthesia recovery time （ end of the op- eration to tracheal extubation time） were recorded. The mean arterial pressure（MAP） and heart rate （HR） in the time before anesthesia induction（T0） , immediately before and after intubation（T1,2） , immediately before and after operation （T3,4 ） , and immediately before tracheal extubation（ T5） in each group were recorded, and the visual analogue scale（VAS） in each group were also recorded. RESULTS The elevation of MAP and HR was more at T2,3,5 than at To in group A （P 〈 0.05 ） and decreased at T1,4 （ P 〈 0.05 ）. Compared with group A, the MAP and HR were significantly decreased at T2,3,5 in group B and group C （P 〈 0.05 ） , the VAS was significantly decreased in group B and group C （P 〈 0.05） , and there was no significant difference in the parameters mentioned above between group B and group C （ P 〉 0.05）. Compared with group C, the anesthesia recovery time was significantly decreased in group A and group B （P 〈 0.05） , and there was no significant difference between group A and group B （P 〉 0.05 ）. CONCLUSION The optimum dose of oxycodone anesthesia induction is 0.25 mg·kg^-1 in elderly patients with laparoscopic cholecystectomy.
出处
《中国临床药学杂志》
CAS
2017年第5期320-323,共4页
Chinese Journal of Clinical Pharmacy
