地佐辛对老年患者七氟醚吸入诱导气管插管的影响
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摘要
目的探究地佐辛对老年患者七氟醚吸入诱导气管插管的影响。方法选取2017年1月～2018年9月我院收治的50例择期全麻手术并于术中行七氟醚吸入诱导气管插管的老年患者作为研究对象,按照随机数字表法将其分为实验组(25例)和对照组(25例)。实验组患者麻醉诱导前静脉注射0.2 mg/kg地佐辛,对照组患者麻醉诱导前静脉注射10 ml生理盐水,比较两组患者注射药物前(T_1)、注射药物后10 min(T_2)、气管插管前1 min(T_3)、气管插管后1 min(T_4)及气管插管后10 min(T_5)的血流动力学指标[心脏指数(CI)、中心静脉压(CVP)和血氧饱和度(SpO_2)]、应激变化指标[心率(HR)、收缩压(SBP)、舒张压(DBP)、呼吸频率(RR)]及不良反应发生情况。结果两组患者T_1的CI、CVP及SpO_2比较,差异无统计学意义(P>0.05);两组患者T_2、T_3、T_4、T_5的CI、CVP及SpO_2均低于T_1,差异有统计学意义(P<0.05);两组患者T_2、T_3、T_4、T_5的CI、CVP比较,差异无统计学意义(P>0.05);实验组患者T_2、T_3、T_4、T_5的SpO_2均高于对照组,差异有统计学意义(P<0.05)。两组患者T_1的HR、SBP、DBP及RR比较,差异无统计学意义(P>0.05);实验组患者T_2、T_3、T_4、T_5的HR、SBP、DBP及RR均低于T_1,差异有统计学意义(P<0.05);对照组患者T_3、T_4、T_5的HR、SBP、DBP及RR均低于T_1,差异有统计学意义(P<0.05);对照组患者T_1与T_2的HR、SBP、DBP及RR比较,差异无统计学意义(P>0.05);实验组患者T_2、T_3、T_4、T_5的HR、SBP、DBP及RR均低于对照组,差异有统计学意义(P<0.05)。实验组患者麻醉期间的不良反应总发生率为4.00%,明显低于对照组的32.00%,差异有统计学意义(P<0.05)。结论地佐辛用于老年七氟醚吸入诱导气管插管能够改善患者的SpO_2,有稳定的血流动力学指标,插管后应激反应较小,药物安全性高。
Objective To investigate the effect of Dizocine on inhaled tracheal intubation induced by Sevoflurane in elderly patients. Methods A total of 50 elderly patients who underwent general anesthesia selective surgery and Sevoflurane inhalation-induced tracheal intubation admitted to our hospital from January 2017 to September 2018 were selected as subjects. According to the random number table method, they were divided into the experimental group(25 cases)and the control group(25 cases). In the experimental group, 0.2 mg/kg of Dizocine was injected intravenously before induction of anesthesia, and 10 ml of normal saline was given intravenously before induction of anesthesia in the control group. The demodynamic parameters(cardiac index [CI], central venous pressure [CVP] and oxygen saturation[SpO_2]), stress indicators(heart rate [HR], systolic blood pressure [SBP], diastolic blood pressure [DBP], respiratory rate[RR]) before injecting drugs(T_1), 10 min(T_2) after injecting drugs, 1 min(T_3) before tracheal intubation, 1 min(T_4) after tracheal intubation, and 10 min after tracheal intubation(T_5) and the incidence of adverse reactions were compared between the two groups. Results There were no significant differences in CI, CVP and SpO_2 at T_1 between the two groups(P>0.05). The CI, CVP and SpO_2 in the two groups at T_2, T_3, T_4 and T_5 were lower than those at T_1, and the differences were statistically significant(P<0.05). There were no significant differences in CI and CVP at T_2, T_3, T_4 and T_5 between the two groups(P>0.05). The SpO_2 in the experimental group at T_2, T_3, T_4 and T_5 was higher than that in the control group, and the differences were statistically significant(P <0.05). There were no significant differences in HR, SBP,DBP and RR at T_1 between the two groups(P>0.05). The HR, SBP, DBP and RR at T_2, T_3, T_4 and T_5 in the experimental group were lower than those at T_1, and the differences were statistically significant(P<0.05). The HR, SBP, DBP and RR at T_3, T_4 and T_5 in the control group were lower than those at T_1, and the differences were statistically significant(P<0.05). There were no significant differences in HR, SBP, DBP and RR between T_1 and T_2 in the control group(P>0.05). The HR, SBP, DBP and RR at T_2, T_3, T_4 and T_5 in the experimental group were lower than those in the control group, and the differences were statistically significant(P<0.05). The total incidence rate of adverse reactions during the anesthesia of the experimental group was 4.00%, which was significantly lower than that of the control group(32.00%), and the difference was statistically significant(P<0.05). Conclusion Dizocine for the inhaled tracheal inhalation induced by Sevoflurane can improve the Sp O_2 of patients, and it has stable hemodynamic parameters, less stress response after intubation, with high drug safety.
Objective To investigate the effect of Dizocine on inhaled tracheal intubation induced by Sevoflurane in elderly patients. Methods A total of 50 elderly patients who underwent general anesthesia selective surgery and Sevoflurane inhalation-induced tracheal intubation admitted to our hospital from January 2017 to September 2018 were selected as subjects. According to the random number table method, they were divided into the experimental group(25 cases)and the control group(25 cases). In the experimental group, 0.2 mg/kg of Dizocine was injected intravenously before induction of anesthesia, and 10 ml of normal saline was given intravenously before induction of anesthesia in the control group. The demodynamic parameters(cardiac index [CI], central venous pressure [CVP] and oxygen saturation[SpO_2]), stress indicators(heart rate [HR], systolic blood pressure [SBP], diastolic blood pressure [DBP], respiratory rate[RR]) before injecting drugs(T_1), 10 min(T_2) after injecting drugs, 1 min(T_3) before tracheal intubation, 1 min(T_4) after tracheal intubation, and 10 min after tracheal intubation(T_5) and the incidence of adverse reactions were compared between the two groups. Results There were no significant differences in CI, CVP and SpO_2 at T_1 between the two groups(P>0.05). The CI, CVP and SpO_2 in the two groups at T_2, T_3, T_4 and T_5 were lower than those at T_1, and the differences were statistically significant(P<0.05). There were no significant differences in CI and CVP at T_2, T_3, T_4 and T_5 between the two groups(P>0.05). The SpO_2 in the experimental group at T_2, T_3, T_4 and T_5 was higher than that in the control group, and the differences were statistically significant(P <0.05). There were no significant differences in HR, SBP,DBP and RR at T_1 between the two groups(P>0.05). The HR, SBP, DBP and RR at T_2, T_3, T_4 and T_5 in the experimental group were lower than those at T_1, and the differences were statistically significant(P<0.05). The HR, SBP, DBP and RR at T_3, T_4 and T_5 in the control group were lower than those at T_1, and the differences were statistically significant(P<0.05). There were no significant differences in HR, SBP, DBP and RR between T_1 and T_2 in the control group(P>0.05). The HR, SBP, DBP and RR at T_2, T_3, T_4 and T_5 in the experimental group were lower than those in the control group, and the differences were statistically significant(P<0.05). The total incidence rate of adverse reactions during the anesthesia of the experimental group was 4.00%, which was significantly lower than that of the control group(32.00%), and the difference was statistically significant(P<0.05). Conclusion Dizocine for the inhaled tracheal inhalation induced by Sevoflurane can improve the Sp O_2 of patients, and it has stable hemodynamic parameters, less stress response after intubation, with high drug safety.
引文
[1]方亮.地佐辛对舒芬太尼诱发的全麻诱导期呛咳反应的抑制作用[J].临床医药文献电子杂志,2016,3(27):5457.
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[7]李东瀛,李波,张模强.不同剂量纳洛酮对地佐辛麻醉后患者复苏质量的影响[J].中国基层医药,2016,23(20):34-35.
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[9]董维森,李洁,陈赫军,等.地佐辛注射液治疗肿瘤患者持续疼痛的系统评价[J].中国疼痛医学杂志,2016,22(2):123-127.
[10]邱建斌.地佐辛在全麻诱导期预防呛咳反应的体会[J].齐齐哈尔医学院学报,2016,37(7):888-889.
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[12]李克寒,杨惠敏,郭丹.瑞芬太尼或不同剂量地佐辛全麻诱导期喉罩置入对丙泊酚半数有效血浆靶浓度的影响[J].蚌埠医学院学报,2016,41(10):1299-1301.
[13]熊志刚,郑永顺,刘晓峰.地佐辛静脉自控镇痛对剖宫产产妇血清泌乳素浓度的影响[J].第三军医大学学报,2016,38(12):1462-1465.
[14]梁跃新.辅用布托啡诺与地佐辛全麻诱导中血流动力学变化的比较[J].临床普外科电子杂志,2017,5(1):36-38.
[15]Feng C,Feng M,Jiao R,et al.Effect of Dezocine on IL-12and IL-10 secretion and lymphocyte activation by culturing dendritic cells from human umbilical cord blood[J].Eur J Pharmacol,2017,796:110-114.
[16]Xiang Y,Ye W,Sun N,et al.Analgesic and sedative effects of Dezocine and Midazolam during vitrectomy[J].Curr Eye Res,2016,41(11):1460-1464.
[17]Li NN,Huang YQ,Huang LE,et al.Dezocine antagonizes morphine analges ia upon simultaneous administration in rodent models of acute nociception[J].Pain Physician,2017,20(3):E401-E409.
[18]Xu BB,Zhao XL,Xu GP.Clinical study of anesthetization by dezocine combined with propofol for indolent colonos copy[J].World J Gastroenterol,2016,22(24):5609-5615.
[19]Li Z,Wu H,He R,et al.Oxycodone versus dezocine for postoperative analgesia in patients with cervical cancer treated with radical surgery[J].J Cancer Res Ther,2016,12(S):27-29.
[20]黄典,杨春燕,廖益永,等.不同剂量地佐辛复合七氟醚对上腹部手术患者麻醉效果及血流动力学的影响[J].实用药物与临床,2016,19(10):1273-1276.
[21]王志兵,汪国海.地佐辛在复合七氟醚上腹部手术患者中应用对七氟醚毒性及麻醉效果影响最佳剂量[J].中国医药科学,2016,6(12):108-111.
[2]赵保军,黄佳洋.预防应用地佐辛对扁桃体切除手术患儿七氟醚吸入麻醉苏醒质量的影响[J].武汉大学学报(医学版),2016,37(6):1027-1030.
[3]马海燕,詹峰,马婷婷.地佐辛复合丙泊酚麻醉诱导应用于无痛人工流产的可行性研究[J].临床合理用药杂志,2017,10(17):75-76.
[4]原见春,曹波,秦忠林.地佐辛对老年高血压患者全麻诱导期的影响[J].云南医药,2018,4(2):12-14.
[5]秦东全,马赫,卢可健,等.地佐辛对全身麻醉诱导气管插管心血管反应的影响及安全性分析[J].吉林医学,2017,7(12):22-24.
[6]王左锋,刘庆.地佐辛对老年患者七氟醚吸入诱导MAC的影响[J].现代临床医学,2017,43(5):353-355.
[7]李东瀛,李波,张模强.不同剂量纳洛酮对地佐辛麻醉后患者复苏质量的影响[J].中国基层医药,2016,23(20):34-35.
[8]王左锋,刘庆,江敏,等.地佐辛对老年患者吸入诱导气管插管应激的影响[J].实用医院临床杂志,2016,13(6):51-53.
[9]董维森,李洁,陈赫军,等.地佐辛注射液治疗肿瘤患者持续疼痛的系统评价[J].中国疼痛医学杂志,2016,22(2):123-127.
[10]邱建斌.地佐辛在全麻诱导期预防呛咳反应的体会[J].齐齐哈尔医学院学报,2016,37(7):888-889.
[11]范建军.地佐辛对全麻诱导气管插管心血管反应的影响[J].包头医学院学报,2016,32(7):41-42.
[12]李克寒,杨惠敏,郭丹.瑞芬太尼或不同剂量地佐辛全麻诱导期喉罩置入对丙泊酚半数有效血浆靶浓度的影响[J].蚌埠医学院学报,2016,41(10):1299-1301.
[13]熊志刚,郑永顺,刘晓峰.地佐辛静脉自控镇痛对剖宫产产妇血清泌乳素浓度的影响[J].第三军医大学学报,2016,38(12):1462-1465.
[14]梁跃新.辅用布托啡诺与地佐辛全麻诱导中血流动力学变化的比较[J].临床普外科电子杂志,2017,5(1):36-38.
[15]Feng C,Feng M,Jiao R,et al.Effect of Dezocine on IL-12and IL-10 secretion and lymphocyte activation by culturing dendritic cells from human umbilical cord blood[J].Eur J Pharmacol,2017,796:110-114.
[16]Xiang Y,Ye W,Sun N,et al.Analgesic and sedative effects of Dezocine and Midazolam during vitrectomy[J].Curr Eye Res,2016,41(11):1460-1464.
[17]Li NN,Huang YQ,Huang LE,et al.Dezocine antagonizes morphine analges ia upon simultaneous administration in rodent models of acute nociception[J].Pain Physician,2017,20(3):E401-E409.
[18]Xu BB,Zhao XL,Xu GP.Clinical study of anesthetization by dezocine combined with propofol for indolent colonos copy[J].World J Gastroenterol,2016,22(24):5609-5615.
[19]Li Z,Wu H,He R,et al.Oxycodone versus dezocine for postoperative analgesia in patients with cervical cancer treated with radical surgery[J].J Cancer Res Ther,2016,12(S):27-29.
[20]黄典,杨春燕,廖益永,等.不同剂量地佐辛复合七氟醚对上腹部手术患者麻醉效果及血流动力学的影响[J].实用药物与临床,2016,19(10):1273-1276.
[21]王志兵,汪国海.地佐辛在复合七氟醚上腹部手术患者中应用对七氟醚毒性及麻醉效果影响最佳剂量[J].中国医药科学,2016,6(12):108-111.