摘要
目的:探究不同剂量羟考酮应用于手术全麻的临床效果。方法:选取116例外科手术全麻患者为研究对象,随机数表法分为大剂量组与小剂量组各58例。大剂量组于麻醉诱导后给予0.3mg/kg羟考酮,小剂量组则给予0.15mg/kg羟考酮。比较插管前(T 0)、气管插管后即刻(T 1)、气管插管后1min(T 2)、气管插管后3min(T 3)、气管插管后10min(T 4)时两组血流动力学参数[心率(HR)、收缩压(SBP)、舒张压(DBP)]变化,分析T 0与拔管后即刻(T 5)时两组应激反应指标[血清去甲肾上腺素(NE)、血浆皮质醇(COR)、血糖(GLU)]变化,观察两组围苏醒期基本指标及注射后10min内药物不良反应发生率差异。结果:T 1时,两组HR、SBP、DBP水平均较T 0时有显著下降(P<0.05),但组间比较均无统计学意义(P>0.05)。T 2、T 3时,两组HR、SBP、DBP水平均较T 0时有显著提升,且大剂量组明显低于同期小剂量组(P<0.05)。T 4时,两组HR、SBP、DBP水平均较T 0时有显著下降,且大剂量组明显低于同期小剂量组(P<0.05)。T 5时,两组NE、COR、GLU水平均较T 0时有显著提升,且大剂量组明显高于同期小剂量组(P<0.05)。两组围苏醒期自主呼吸时间、呼之睁眼时间、呼之握拳时间及送返病房时间比较均无统计学意义(P>0.05)。注射后10min内,两组低血压、舌后坠、呛咳、高碳酸血症发生率比较均无统计学意义(P>0.05)。结论:麻醉诱导后应用大剂量羟考酮能有效抑制气管插管应激反应,并促进血流动力学稳定,对维持利于手术操作施行的麻醉深度有利。
Objective:To explore the clinical effects of different doses of oxycodone in general anesthesia of surgery.Methods:116 patients with general anesthesia of surgery were selected for the study and were randomly divided into high-dose group and low-dose group,with 58 cases in each group.High-dose group was given 0.3 mg/kg oxycodone after anesthesia induction,and low-dose group was given 0.15 mg/kg oxycodone.Hemodynamics parameters[heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP)]were compared between the two groups before intubation(T 0),immediately after tracheal intubation(T 1),at 1min after tracheal intubation(T 2),at 3min after tracheal intubation(T 3)and at 10min after tracheal intubation(T 4).The stress response indicators[serum norepinephrine(NE),plasma cortisol(COR),blood glucose(GLU)]were analyzed at T 0 and immediately after extubation(T 5)in the two groups,and the basic indicators during peri-recovery period and incidence rate of adverse drug reactions within 10min after injection were observed in the two groups.Results:At T 1,the levels of HR,SBP and DBP in the two groups were significantly decreased compared with those at T 0(P<0.05),but there were no significant differences between the two groups(P>0.05).At T 2 and T 3,the levels of HR,SBP and DBP in the two groups were significantly increased compared with those at T 0,and the levels in high-dose group were significantly lower than those in low-dose group(P<0.05).At T 4,the levels of HR,SBP and DBP in the two groups were significantly decreased compared with those at T 0,and the levels in high-dose group were significantly lower than those in low-dose group(P<0.05).At T 5,the levels of NE,COR and GLU in the two groups were significantly increased compared with those at T 0,and the levels in high-dose group were significantly higher than those in low-dose group(P<0.05).There were no significant differences between the two groups in the spontaneous breathing time,duration of eye opening,duration of fist making and time of return
作者
殷俊茹
赵建奎
杨永慧
牛江涛
YIN Junru;ZHAO Jiankui;YANG Yonghui(Second Affiliated Hospital of Air Force Military Medical University,Shaanxi Xi'an 710038,China)
出处
《河北医学》
CAS
2019年第9期1446-1451,共6页
Hebei Medicine
基金
陕西省卫生厅科研基金项目,(编号:2016D130465)
关键词
麻醉诱导
不同剂量
羟考酮
应激反应
血流动力学
Anesthesia induction
Different doses
Oxycodone
Stress response
Hemodynamics
