摘要
目的观察纳布啡联合舒芬太尼对全麻插管期间患者血浆肾上腺素和去甲肾上腺素的影响。方法选取2018年4-10月我院择期手术患者80例,美国麻醉医师协会(ASA)分级I~Ⅱ级,采用随机数字表法分为2组(每组40例):对照组(C组)、纳布啡组(N组)。N组患者静脉给予纳布啡0.2mg/kg,C组患者给予等量的生理盐水。给药后2min进行全麻诱导,待肌肉完全松弛,明视下气管插管。记录6个时间点:给药前(T0)、麻醉诱导前(T1)、气管插管前(T2)、插管即刻(T3)、插管后1min(T4)、插管后5min(T5)的收缩压(SBP)、舒张压(DBP)和心率(HR)。于T0、T2、T3、T4、T5时间点抽取静脉血,采用ELISA法检测去甲肾上腺素(NE)、肾上腺素(E)浓度。观察并记录各组患者诱导期舒芬太尼呛咳发生情况。结果T2时间点C组患者HR明显低于N组,差异有统计学意义(P<0.05)。T3、T4、T5时间点,C组患者SBP、DBP、HR明显高于N组,差异有统计学意义(P<0.05)。T3、T4、T5时间点,C组患者NE和E浓度明显高于N组,差异有统计学意义(P<0.05)。N组患者均未发生呛咳,C组有12例患者发生呛咳(轻度7.5%、中度10%、重度12.5%),两组比较差异有统计学意义(P<0.05)。结论纳布啡0.2mg/kg联合舒芬太尼能有效抑制全麻气管插管期血浆肾上腺素和去甲肾上腺素的分泌,可安全有效地用于全麻诱导期。
Objective To observe the effects of nalbuphine combined with sufentanil on plasma epinephrine ( E) and norepirrephrine ( NE) during general anesthesia intubation. Methods Totally 80 patients admitted to our hospital undergoing elective surgery from April to October in 2018 were chosen. According to the ASA grading (Ⅰ~Ⅱ),80 patients were randomly divided into two groups: control group( group C) and nalbuphine group( group N),40 patients in each group. Patients in control group received 5 ml normal saline and nalbuphine group received nalbuphine at 0. 2 mg /kg. After 2 min,the patient underwent general anesthesia induction. Endotracheal intubation was given to the patient after muscles were completely relaxed. The systolic blood pressure ( SBP),diastolic blood pressure ( DBP) and heart rate ( HR) of patients were recorded before administration ( T0 ),immediately before general anesthesia induction ( T1 ),before intubation ( T2 ),at the time of intubation( T3 ),1 min after intubation ( T4 ), and 5 min after intubation ( T5 ). Blood samples were taken at T0 ,T2 ,T3 ,T4 and T5 for determination of plasma concentration of NE and E using the method of ELISA. The incidence and severity of cough in patients were evaluated during general anesthesia induction. Results HR of group C at T2 was obviously lower than that of group N( P < 0. 05). The SBP, DBP and HR in group N were obviously lower than those of control group at T3 ,T4 and T5 ( P < 0. 05). The concentration of E and NE were obviously lower than those of control group at T3 ,T4 and T5 ( P < 0. 05). No cough happened in group N, while there were 12 patients with cough in group C( severity of cough: mild,7. 5%;moderate,10%;severe,12. 5%)( P < 0. 05). Conclusion Nabuphine 0. 2 mg /kg combined with sufentanil can effectively inhibit the secretion of plasma E and NE during the intubation of general anesthesia,which can be safely and effectively used in the induction period of general anesthesia.
作者
邹宏运
陈菁菁
徐光红
OU Hong-yun;CHEN Jing-jing;XU Guang-hong(Department of Anesthesiology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)
出处
《实用药物与临床》
CAS
2019年第7期701-704,共4页
Practical Pharmacy and Clinical Remedies
关键词
纳布啡
气管插管
肾上腺素
去甲肾上腺素
呛咳
Nalbuphine
Endotracheal intubation
Epinephrine
Norepirrephrine
Cough
