摘要
目的 探讨术中应用纳布啡对快通道心脏麻醉下行心脏瓣膜手术的患者术后苏醒质量及神经功能的影响。方法 选取择期在快通道心脏麻醉下进行心脏瓣膜手术治疗的120例患者,随机分为观察组与对照组,每组60例。对照组给予快通道心脏麻醉,观察组给予快通道心脏麻醉的同时在手术结束前30 min静脉注射纳布啡0.2 mg/kg。比较两组患者的苏醒指标、镇痛效果、镇静效果及术后神经功能指标。结果 两组患者的初醒所需时间差异无统计学意义(P>0.05),观察组患者的清醒所需时间与自主呼吸恢复所需时间均短于对照组(均P<0.05)。在术后不同时间点,观察组患者的疼痛视觉模拟量表评分均低于对照组,Ramsay评分均高于对照组(均P<0.05)。观察组患者术后12 h的血清β淀粉样蛋白、S100β蛋白、神经元特异性烯醇化酶水平均低于对照组(均P<0.05)。结论 在快通道心脏麻醉下行心脏瓣膜手术同时给予纳布啡治疗,可缩短患者清醒所需时间与自主呼吸恢复所需时间,可获得较好的术后镇痛、镇静效果,且对神经功能影响较小。
Objective To investigate the effect of intraoperative nalbuphine application to postoperative recovery quality and neurological function in patients undergoing cardiac valve surgery via fast-track cardiac anesthesia.Methods A total of 120 patients undergoing elective cardiac valve surgery via fast-track cardiac anesthesia were selected and randomly divided into observation group or control group,with 60 cases in each group.The control group was given fast-track cardiac anesthesia,whereas the observation group was given fast-track cardiac anesthesia and intravenous injection of 0.2 mg/kg nalbuphine 30 minutes before the end of operation at the same time.The recovery indices,analgesic effect,sedative effect,and postoperative neurological function indices were compared between the two groups.Results There was no statistically significant difference of time to first recovery between the two groups(P>0.05).The patients in the observation group needed shorter time to recovery and to return of autonomous respiration as compared with the control group(all P<0.05).The observation group exhibited a lower Visual Analogue Scale score for pain,whereas higher Ramsay score at various time points after operation in the comparison of the control group(all P<0.05).The observation group expressed lower levels of serum amyloid-βprotein,S100βprotein,neuron specific enolase 12 hours after operation as compared with the control group(all P<0.05).Conclusion Simultaneosly employing intraoperative nalbuphine therapy in patients undergoing cardiac valve surgery via fast-track cardiac anesthesia can shorten time to recovery and to return of autonomous respiration in patients,exerting preferable effects of postoperative analgesia and sedation,and slight influence on neurological function.
作者
罗海鸣
全宗宗
刘茜茜
LUO Hai-ming;QUAN Zong-zong;LIU Xi-xi(Department of Anesthesiology,Shanghai Ninth People,s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Department of Cardiology,Haian Hospital of Traditional Chinese Medicine,Haian 226600,Jiangsu,China)
出处
《广西医学》
CAS
2022年第13期1453-1456,共4页
Guangxi Medical Journal
基金
江苏省南通市卫生健康委员会科研课题(MB2019038)。
关键词
心脏瓣膜手术
快通道心脏麻醉
纳布啡
苏醒时间
镇静
镇痛
神经功能
Cardiac valve surgery
Fast-track cardiac anesthesia
Nalbuphine
Time to recovery
Sedation
Analgesia
Neurological function
