羟考酮对神经介入手术患者全身麻醉苏醒质量的影响
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摘要
目的:探讨羟考酮对神经介入手术患者全身麻醉(全麻)后苏醒质量的影响.方法:选择择期在全麻下行神经介入手术的患者60例,年龄55~75岁,美国麻醉医师协会(ASA)Ⅰ~Ⅲ级,随机分为羟考酮组(Oxy组)和芬太尼组(F组),每组30例.手术结束前15 min两组患者分别给予羟考酮0.1 mg/kg、芬太尼1μg/kg,观察两组患者麻醉后苏醒情况,并记录拔管前1 min(T1)、拔管后1 min(T2)、3 min(T3)、5 min(T4)的血流动力学指标[(平均动脉压(MAP),心率(HR)]、镇静镇痛评分及术毕不良反应(躁动、呼吸抑制、恶心呕吐等)的发生情况.结果:与F组比较,Oxy组患者麻醉苏醒时间更短,拔管后前后血流动力学变化更小,镇静效果更优,术后恶心和呼吸抑制的发生率更低且差异均有统计学意义(P<0.05).结论:羟考酮与芬太尼相比能更有效地抑制神经介入手术患者拔管期的应激反应,改善苏醒质量.
Aim: To investigate the influence of oxycodone on the quality of recovery from general anesthesia in interventional neuroradiology procedures. Methods: Sixty patients aged 55-75 years,ASA I-III,were randomly divided into two groups. Oxy group was given oxycodone 0. 1mg / kg fifteen minutes before the end of the surgery while the F group was given fentanil 1ug / kg at the same time. HR,MAP changes of patients in the two groups were observed at different time points: 1 minute before extubation( T1),1 minute after extubation( T2),3 minutes after extubation( T3),5 minutes after extubation( T4).Recovery times,postoperative adverse reactions( postoperative agitation,respiratory depression,nausea and vomiting) and changes in sedation,pain during recovery were recorded. Results: Compared with the F group,the recovery times in Oxy group were shorter and changes of MAP and HR at different time points after the surgery in the Oxy group were lower( P < 0. 05). The Ramsay scores were higer and the occurrence of postoperative nausea and respiratory depression was lower in the Oxy group than in F group( P < 0. 05). Conclusion: Oxycodone can depress the cardiovascular response during extubation of anes-thesia effectively,improving the quality of recovery time of the neuroradiology procedures.
Aim: To investigate the influence of oxycodone on the quality of recovery from general anesthesia in interventional neuroradiology procedures. Methods: Sixty patients aged 55-75 years,ASA I-III,were randomly divided into two groups. Oxy group was given oxycodone 0. 1mg / kg fifteen minutes before the end of the surgery while the F group was given fentanil 1ug / kg at the same time. HR,MAP changes of patients in the two groups were observed at different time points: 1 minute before extubation( T1),1 minute after extubation( T2),3 minutes after extubation( T3),5 minutes after extubation( T4).Recovery times,postoperative adverse reactions( postoperative agitation,respiratory depression,nausea and vomiting) and changes in sedation,pain during recovery were recorded. Results: Compared with the F group,the recovery times in Oxy group were shorter and changes of MAP and HR at different time points after the surgery in the Oxy group were lower( P < 0. 05). The Ramsay scores were higer and the occurrence of postoperative nausea and respiratory depression was lower in the Oxy group than in F group( P < 0. 05). Conclusion: Oxycodone can depress the cardiovascular response during extubation of anes-thesia effectively,improving the quality of recovery time of the neuroradiology procedures.
引文
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[9]KOCH S,AHLBURG P,SPANSBER N,et al.Oxycodone vs.fentanyl in the treatment of early postoperative pain after laparoscopic cholecystectomy:a randomized doubleblind study[J].Acta Anaesthesiol Scand,2008,52(6):845-850.
[10]BUDDE A O,METS B.Pro:Etomidate Is the Ideal Induction Agent for a Cardiac Anesthetic[J].Journal of Cardiothoracic and Vascular Anesthesia,2013,27(1):180-183.
[2]FULTON B,SORKIN E M.Propofol:An overview of its pharmacology and a review of its clinical efficacy in intensive care sedation[J].Drugs,1995,50(4):636-657.
[3]HAYMAN M W,PALEOLOGOS M S,KAM P C A.Interventional neuroradiological procedures—a review for anaesthetists[J].Anaesth Intensive Care,2013,41(2):184-201.
[4]王庚,吴新民.瑞芬太尼复合麻醉患者术后急性阿片类药物耐受的发生[J].中华麻醉学杂志,2007,27(5):389-392.
[5]李潇湘,蔡宏伟.盐酸羟考酮注射液对腹腔镜下胃癌根治术老年患者全麻苏醒期的影响[J].医学临床研究,2015,32(3):588-590.
[6]王越洪,林派冲,陈达强.芬太尼麻醉手术中血糖和胰岛素的变化[J].暨南大学学报(自然科学与医学版),1999,20(4):85-87.
[7]丛露,王珊娟,杭阳楠.芬太尼、舒芬太尼、瑞芬太尼对呼吸功能的影响[J].实用疼痛学杂志,2007,5(3):379-383.
[8]LIGUORI S,MICHELETTO M G,BRUNO L.Pharmacological approach to chronic visceral pain.Focus on oxycodone controlled release:an open multicentric study[J].European Review for Medical and Pharmacological Sciences,2010,14(3):185-190.
[9]KOCH S,AHLBURG P,SPANSBER N,et al.Oxycodone vs.fentanyl in the treatment of early postoperative pain after laparoscopic cholecystectomy:a randomized doubleblind study[J].Acta Anaesthesiol Scand,2008,52(6):845-850.
[10]BUDDE A O,METS B.Pro:Etomidate Is the Ideal Induction Agent for a Cardiac Anesthetic[J].Journal of Cardiothoracic and Vascular Anesthesia,2013,27(1):180-183.