摘要
目的:观察静脉注射纳布啡用于全身麻醉苏醒期的临床作用。方法:选择择期行全身麻醉手术患者100例,ASAⅠ-Ⅱ级,随机分为观察组和对照组各50例。麻醉维持均采用瑞芬太尼泵注与七氟烷吸入。麻醉维持结束时,观察组静脉注射10 mg纳布啡(5 ml生理盐水溶解,5秒匀速注射完毕);对照组静脉注射5 ml生理盐水(5秒匀速注射完毕)。记录患者手术时间、自主呼吸恢复时间、睁眼时间、拔管时间、拔管后特点时间MAP、HR、VAS评分、Ramsay评分躁动、嗜睡、恶心、呕吐、呼吸抑制情况。结果:试验组与对照组比较,手术时间、自主呼吸恢复时间、睁眼时间和拔管时间、嗜睡、恶心、呕吐、呼吸抑制比较,差异无统计学意义(P>0.05);试验组拔管前后MAP、HR、VAS评分及躁动发生率明显低于对照组,Ramsay评分明显高于对照组,差异有统计学意义(P<0.05)。结论:全身麻醉苏醒期,纳布啡有效抑制瑞芬太尼引起的痛觉过敏及七氟烷引起的躁动,具有临床可行性。
Objective To observe the clinical effect of intravenous injection of nalbuphine for the recovery period of general anesthesia. Method 100 patients undergoing general anesthesia,ASA Ⅰ-Ⅱ,were randomly divided into 50 cases in the observation group and the control group. Remifentanil infusion and sevoflurane inhalation were used in the maintenance of anesthesia. At the end of anesthesia maintainance,the observation group will be injected 10 mg nalbuphine（ diluted by 5 ml 0. 9% Na Cl,with the constant speed of 1 ml/second）; Control group will be injected 5 ml saline intravenously（ speed of 1 ml/second）. Records of the patients with operation time,spontaneous breathing recovery time,time to eye opening,extubation time and MAP,HR,VAS score,Ramsay score at the specific time after extubation,irritability,lethargy,nausea and vomiting,respiratory depression. Results To make the comparisionbetween experimental group and control group,there was no statistically significant difference of operation time,the recovery time of spontaneous breathing,the eye opening time and theextubation time,lethargy,nausea and vomiting,respiratory depression（ P 0. 05）. The incidence of and agitationin the experimental group was significantly lower than that in the control group,and the difference was statistically significant（ P 0. 05）. the characteristics of MAP,HR,VAS score,Ramsay score atthe specific time after extubation between the two groups was statistically significant difference. Conclusion The period of general anesthesia recovery,nalbuphine effectively inhibit the hyperalgesia caused by remifentanil and agitation induced sevoflurane,existing the clinical feasibility.
作者
张括
ZHANG Kuo(Department of Anesthesiology,the First College of Clinical Medical Science of Three Gorges University,Yichang Central People＇s Hospital,Yichang 443003,China)
出处
《吉林医学》
CAS
2018年第9期1678-1680,共3页
Jilin Medical Journal
关键词
纳布啡
全身麻醉
苏醒
痛觉过敏
躁动
Nalbuphine
General anesthesia
Recovery
Hyperalgesia
Agitation
