摘要
目的:探讨纳布啡在预防小儿唇腭裂手术患者应激反应及苏醒期躁动方面的临床效果。方法:选取2019年9月-2019年12月在西安交通大学口腔医院整形外科就诊的100例小儿唇腭裂手术患者,随机分为纳布啡组(N组)和对照组(C组)。其中,N组患者在麻醉诱导时按公斤体重0.2mg推注纳布啡,而C组患者则给予同等剂量且含0.9%氯化钠的注射液。在麻醉诱导前(T0)、术毕(T1)和术后30min(T2)采集两组患者的外周静脉血测定应激反应指标(如:血糖、皮质醇和去甲肾上腺素),术毕记录苏醒指标(如:自主呼吸恢复时间和苏醒时间),并利用Riker镇静-躁动评分标准评价两组患者苏醒期的躁动情况。结果:T0时两组患者体内各项应激指标所呈现的差异性无统计学意义(P>0.05);与T0时相比,两组患者体内各项应激指标含量在T1和T2时明显升高,且具有统计学意义(P<0.05);与C组相应时刻相比,N组患者体内各项应激指标数值在T1和T2时期明显降低,且差异性具有统计学意义(P<0.05)。与此同时,两组患者在术毕时苏醒指标差异性比较无统计学意义(P>0.05)。与C组患者相比,N组患者在苏醒期的躁动发生率显著降低,且Riker镇静-躁动评分值也明显降低,其数值差异具有统计学意义(P<0.05)。结论:在小儿唇腭裂手术中,纳布啡可有效降低患者的应激反应水平,能够降低患者在苏醒期躁动的程度及其发生频率,具有良好的镇静效果,且不会影响患者苏醒期的恢复情况,值得在小儿临床麻醉上推广应用。
Objective This study aims to investigate the clinical effects of nabulphine on the prevention of stress response and emergence agitation in children with cleft lip and palate operation.Methods A total of 100 patients undergoing pediatric cleft lip and palate surgery at the Department of Plastic Surgery,Stomatological Hospital of Xi'an Jiaotong University from September 2019 to December 2019 were randomly divided into nalbuphine group(group N)and control group(group C).Among them,patients in group N were injected with nbuphine at 0.2mg per kg of body weight during anesthesia induction,and patients in group C were given the same dose of 0.9%sodium chloride injection.Peripheral venous blood of the two groups was collected at three periods before induction of anesthesia(T0),after surgery(T1)and 30 min after surgery(T2)to measure stress response indicators(e.g.,blood glucose,cortisol and noradrenaline),indicators of resuscitation(e.g.,recovery time of spontaneous breathing and time of resuscitation)were recorded at the end of the operation,and use the Riker sedationrestlessness scale to evaluate the emergence agitation of the two groups of patients.Results There was no statistically significant difference in various stress indicators between the two groups at T0(P>0.05).Compared with T0,the difference of various stress indicators between the two groups at T1 and T2 were significantly increased,and presented statistically significant differences(P<0.05).Compared with group C at the corresponding time,the values of various stress indicators in group N decreased significantly at T1 and T2,and the difference was statistically significant(P<0.05).Meanwhile,there was no significant difference in the recovery index between the two groups after surgery(P>0.05).Compared with group C,the incidence of agitation in group N was significantly reduced during the recovery period,and the Riker sedation-agitation score also decreased significantly(P<0.05).Conclusion In children's cleft lip and palate surgery,nabulphine can effectively
作者
武婷
郭亚琨
李乐
张丽娜
潘旭
王智
WU Ting;GUO Ya-kun;LI Le;ZHANG Li-na;PAN Xu;WANG Zhi(Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research,Xi’an 710004,Shaanxi,China;Department of Anesthesiology,Hospital of Stomatology,Xi’an Jiaotong University,Xi’an 710004,Shaanxi,China)
出处
《中国美容医学》
CAS
2021年第3期76-79,共4页
Chinese Journal of Aesthetic Medicine
基金
陕西省重点研发计划—一般项目社会发展领域(编号:2018SF-057)。
关键词
纳布啡
小儿
唇腭裂
应激反应
苏醒期躁动
nalbuphine
children
cleft lip and palate
stress response
emergence agitation
