摘要
目的观察不同剂量羟考酮注射液用于老年患者全麻诱导的安全性并研究其疗效。方法利用回顾性研究的方法, 纳入湖南省人民医院2019年2月至2021年2月收治的100例年龄65~80岁的全身麻醉患者。根据全麻诱导使用的羟考酮剂量, 分为4组, 每组25例:O1组(羟考酮注射液0.275 mg/kg)、O2组(羟考酮注射液0.325 mg/kg)、O3组(羟考酮注射液0.375 mg/kg), 并以舒芬太尼诱导(0.3 μg/kg)作为对照组(F组)。记录4组患者全麻诱导前(T0)、全麻诱导后(T1)、插管即刻(T2)、插管后10 min(T3)、插管后30 min(T4)的血流动力学指标:平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2), 计算心率与收缩压乘积(RPP);抽取T0、T4时的静脉血检测应激相关指标:血糖、去甲肾上腺素(NE)和白细胞介素(IL)-6浓度;通过记录各组患者拔管和离室时间以及拔管后不良反应评估其安全性。两两比较使用LSD-t检验。结果各组内不同时间血流动力学指标与T0时比较, MAP值在从T2时间点开始均明显降低[(94.5±12.6)、(92.6±15.7)、(96.0±13.9)、(93.0±17.0) mmHg低于(100.7±13.4)、(100.5±10.7)、(101.6±10.9)、(99.0±15.1) mmHg], 差异有统计学意义(F=3.261、7.321、5.293、7.614, P<0.05);O1组及F组患者HR值在T3时间点开始降低[(70.52±11.8)、(76.44±19.3)次/分高于(75.72±14.1)、(82.20±19.3)次/分], O2组HR在T2时间点开始降低[(72.24±15.3)次/分低于(77.36±17.9)次/分], O3组仅T4时间点降低[(68.32±13.1)次/分低于(74.84±9.7)次/分], 差异有统计学意义(F=3.880、6.045、3.006、7.360, P<0.05);O1、O3组SpO2值在T4时间点上升[(99.0±2.0)%、(99.0±1.7)%高于(97.0±2.4)、(98.0±1.5)%], 差异有统计学意义(F=3.489、3.039, P<0.05);O1、O2和F组RPP值在T2时间点开始下降(9 877±2 635、9 765±3 089、10 381±2 908高于10 992±2 736、11 503±3 203、11 645±3 072), O3组RPP值在T1时间点下降(10 444±2 342高于11 155±2 105), 差异有统计学意义(F=5.342、10.941、6.419�
Objective To observe the safety and efficacy of different doses of oxycodone injection for general anesthesia induction in elderly patients.Methods Using the method of retrospective study,100 general anesthesia patients aged 60-80 years who were admitted to our hospital from February 2019 to February 2021 were included.According to the dose of oxycodone used in general anesthesia induction,the patients were divided into four groups,with 25 cases in each group:O1 group(oxycodone injection 0.275 mg/kg),O2 group(oxycodone injection 0.325 mg/kg),O3 group(oxycodone injection 0.375 mg/kg),and Sufentanil induction(0.3μg/kg)as the control group(group F).Hemodynamic indexes of patients in the four groups were recorded before general anesthesia induction(T0),after general anesthesia induction(T1),immediately after intubation(T2),10 min(T3)and 30 min(T4)after intubation.Mean arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SpO2),rate pressure product(RPP)were calculated.The stress related indexes of blood glucose,norepinephrine(NE)and interleukin(IL)-6 were detected by venous blood samples collected during T0 and T3.The safety of extubation was evaluated by recording the time of extubation and extubation and the adverse reactions after extubation.The LSD-t test was used for pairwise comparison.Results Comparison of hemodynamic indexes at different times in each group with T0:MAP values decreased significantly from T2 time point[(94.5±12.6),(92.6±15.7),(96.0±13.9),(93.0±17.0)mmHg lower than(100.7±13.4),(100.5±10.7),(101.6±10.9),(99.0±15.1)mmHg],the difference was statistically significant(F=3.261,7.321,5.293,7.614,P<0.05);HR values of patients in O1 and F groups began to decrease at T3 time point,and[(70.52±11.8),(76.44±19.3)times/min were higher than(75.72±14.1),(82.20±19.3)times/min],and HR values in O2 group began to decrease at T2 time point[(72.24±15.3)times/min lower than(77.36±17.9)times/min],only T4 time point of O3 group decreased,[(68.32±13.1)times/min lower than(74.84±9.7)times/min],T
作者
黄晓玲
易珍
唐轶珣
胡霞
曹琳
刘际童
张宇
Huang Xiaoling;Yi Zhen;Tang Yixun;Hu Xia;Cao Lin;Liu Jitong;Zhang Yu(Department of Anesthesiology,Hunan Provincial People’s Hospital,the First Affiliated Hospital of Hunan Normal University,Changsha 410005,China)
出处
《中华实验外科杂志》
CAS
北大核心
2023年第8期1606-1610,共5页
Chinese Journal of Experimental Surgery
基金
2022年度仁术基金一般项目(RS2022B01)。
关键词
羟考酮注射液
老年患者
麻醉诱导
Oxycodone injection
Elderly patients
Anesthesia induction
