依他佐辛应用于支撑喉镜手术患者的临床效果观察
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摘要
目的:探讨依他佐辛应用于声门手术对患者围术期血流动力学以及苏醒质量的影响。方法:选取全身麻醉下行声门手术的患者48例,随机分为依他佐辛组(EP组)和生理盐水对照组(CG组),在麻醉诱导前分别给予EP组依他佐辛0.25 mg/kg、CG组等容量盐水。观察指标选择平均动脉压(MAP)和心率(HR),时点选择在诱导开始前(T_1)、插管后即刻(T_2)、插管后3 min(T_3)以及拔管后即刻(T_4)、拔管后3 min(T_5)5个时刻,记录手术时间、从停药到呼唤睁眼的苏醒时间以及到拔除导管的时间,记录所有患者拔管期间躁动程度与呛咳情况以及各级评分的例数。结果:EP组患者T_2～T_4时刻记录的MAP以及T_4时刻记录的HR较T_1时显著升高,差异有统计学意义(P<0.05);CG组T_2～T_4时刻记录的MAP、HR较T_1均升高,差异有统计学意义(P<0.05)。EP组T_2～T_5时刻的MAP以及HR均较CG组显著下降,差异有统计学意义(P<0.05)。EP组的术后发生躁动和呛咳的例数和程度均低于CG组,差异有统计学意义(P<0.05)。结论:依他佐辛能减轻支撑喉镜手术患者插管过程及苏醒期的心血管反应,减少苏醒期躁动与呛咳的发生,未发现延迟苏醒和影响拔管时间。
Objective To explore the effect of eptazocine on hemodynamics and emergence in patients undergoing laryngoscope surgery.Method Forty-eight patients undergoing laryngoscope surgery under general anesthesia were randomized into eptazocine group(group EP) and normal saline of equal volume group as contorl group(group CG).Group EP received intravenous 0.25 mg/kg eptazocine before induction,and Group CG received equal normal saline as a placebo.Mean arterial pressure(MAP),heart rate(HR)were recorded at the time of before indution(T_1),intubation(T_2),3 min after intubation(T_3) and extubation(T_4),3 min after extubation(T_5),as well as the operating time,awakening time,and extubation time.Adverse events such as emergence agitation and cough also were documented.Results MAP at T_2～T_4 and HR at T_4 rose significantly within Group EP than T_1(P<0.05).MAP and HR recorded at T_2～T_4 in Group CG were higher than T_1(P<0.05).Decrease in MAP and HR from T_2～T_5 were significantly greater in Group EP(P<0.05).In Group EP,EA and cough scores were lower than those in Group CG(P<0.05).Conclusion Eptazocine can depress the stress response during intubation and extubaiton petiod,reduce EA and cough in patients undergoing laryngoscope surgery,as well as awakening and extubation time were not prolonged.
Objective To explore the effect of eptazocine on hemodynamics and emergence in patients undergoing laryngoscope surgery.Method Forty-eight patients undergoing laryngoscope surgery under general anesthesia were randomized into eptazocine group(group EP) and normal saline of equal volume group as contorl group(group CG).Group EP received intravenous 0.25 mg/kg eptazocine before induction,and Group CG received equal normal saline as a placebo.Mean arterial pressure(MAP),heart rate(HR)were recorded at the time of before indution(T_1),intubation(T_2),3 min after intubation(T_3) and extubation(T_4),3 min after extubation(T_5),as well as the operating time,awakening time,and extubation time.Adverse events such as emergence agitation and cough also were documented.Results MAP at T_2～T_4 and HR at T_4 rose significantly within Group EP than T_1(P<0.05).MAP and HR recorded at T_2～T_4 in Group CG were higher than T_1(P<0.05).Decrease in MAP and HR from T_2～T_5 were significantly greater in Group EP(P<0.05).In Group EP,EA and cough scores were lower than those in Group CG(P<0.05).Conclusion Eptazocine can depress the stress response during intubation and extubaiton petiod,reduce EA and cough in patients undergoing laryngoscope surgery,as well as awakening and extubation time were not prolonged.
引文
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[10] 田冬冬(综述),聂丽霞,杨保仲,郜旭萍(审校).阿片受体及阿片类药物治疗癌痛的研究进展[J].肿瘤研究与临床,2016,28(9):645.
[11] Kimura T,Murakami H,Sakai H,et al. Cardiohemodynamic and respiratory effects of eptazocine,a new analgesic agent,in anesthetized dogs[J].Nihon Yakurigaku Zasshi Folia Pharmacologica Japonica,1988,91(3):151.
[12] Sadafule NN,Karhade SS.Comparative Study of Efficacy of Preoperative Nalbuphine Hydrochloride and Pentazocine Lactate on Hemodynamic RespoCGe to Tracheal Intubation and Postoperative Analgesia[J].Anesth Essays Res,2018,12(1):218.
[13] Wang N,Wang L,Gao Y,et al.Analgesic Effect of Preoperative Pentazocine for Laparoscopic Cholecystectomy[J].Cureus,2016,8(12):e948.
[14] Anandmay AK,Dass LL,Sharma AK,et al.Clinico-anesthetic changes following administration of propofol alone and in combination of meperidine and pentazocine lactate in dogs[J].Vet World,2016,9(11):1178.
[15] Kawano S,Okada H,Iwamuro M,et al.An effective and safe sedation technique combining target-controlled infusion pump with propofol,intravenous pentazocine,and bispectral index monitoring for peroral double-balloon endoscopy[J].Digestion,2015,91(2):112.
[16] 杨威.利多卡因喉部表面浸润麻醉对支撑喉镜全身麻醉手术患者心血管反应及术后躁动的影响[J].吉林医学,2017,38(11):2103.
[2] Gunalan S,Venkatraman R,Sivarajan G,et al.Comparative Evaluation of Bolus Administration of Dexmedetomidine and Fentanyl for Stress Attenuation During Laryngoscopy and Endotracheal Intubation[J].J Clin Diagn Res,2015,9(9):UC06.
[3] Yao ZY,Jia Z,Xie YH,et al.Analgesic effect of dezocine in different doses on elderly patients undergoing abdominal operation under general anesthesia and its influence on stress respoCGe to postoperative tracheal extubation.Eur Rev Med Pharmacol Sci,2017,21(22):5223.
[4] Kutlesic M S,Kutlesic R M,Mostic-Ilic T.Attenuation of cardiovascular stress response to endotracheal intubation by the use of remifentanil in patients undergoing Cesarean delivery[J].Journal of Anesthesia,2015,30(2):274.
[5] Aoki M,Kaneko S,Watanabe H.Antinociceptive activity of intracisternally and intrathecally administered eptazocine,a novel analgesic,in mice[J].Methods Find Exp Clin Pharmacol,1990,12(1):11.
[6] El-Shmaa CG,El-Baradey GF.The efficacy of labetalol vs dexmedetomidine for attenuation of hemodynamic stress respoCGe to laryngoscopy and endotracheal intubation[J].J Clin Anesth,2016,31:267.
[7] Montazeri K,Kashefi P,Honarmand A,et al.Attenuation of the pressor response to direct laryngoscopy and tracheal Intubation:oral clonidine vs.oral gabapentin premedication[J].Journal of Research in Medical Sciences the Official Journal of Isfahan University of Medical Sciences,2011,16(Suppl1):S377.
[8] Alireza P,Faranak R,Alireza K,et al.Comparison of Remifentanil and Fentanyl Regarding Hemodynamic Changes Due to Endotracheal Intubation in Preeclamptic Parturient Candidate for Cesarean Delivery[J].Anesthesiology & Pain Medicine,2012,2(2):90.
[9] Nazir M,Salim B,Khan FA.Pharmacological agents for reducing the haemodynamic respoCGe to tracheal intubation in paediatric patients:a systematic review[J].Anaesth InteCGive Care,2016,44(6):681.
[10] 田冬冬(综述),聂丽霞,杨保仲,郜旭萍(审校).阿片受体及阿片类药物治疗癌痛的研究进展[J].肿瘤研究与临床,2016,28(9):645.
[11] Kimura T,Murakami H,Sakai H,et al. Cardiohemodynamic and respiratory effects of eptazocine,a new analgesic agent,in anesthetized dogs[J].Nihon Yakurigaku Zasshi Folia Pharmacologica Japonica,1988,91(3):151.
[12] Sadafule NN,Karhade SS.Comparative Study of Efficacy of Preoperative Nalbuphine Hydrochloride and Pentazocine Lactate on Hemodynamic RespoCGe to Tracheal Intubation and Postoperative Analgesia[J].Anesth Essays Res,2018,12(1):218.
[13] Wang N,Wang L,Gao Y,et al.Analgesic Effect of Preoperative Pentazocine for Laparoscopic Cholecystectomy[J].Cureus,2016,8(12):e948.
[14] Anandmay AK,Dass LL,Sharma AK,et al.Clinico-anesthetic changes following administration of propofol alone and in combination of meperidine and pentazocine lactate in dogs[J].Vet World,2016,9(11):1178.
[15] Kawano S,Okada H,Iwamuro M,et al.An effective and safe sedation technique combining target-controlled infusion pump with propofol,intravenous pentazocine,and bispectral index monitoring for peroral double-balloon endoscopy[J].Digestion,2015,91(2):112.
[16] 杨威.利多卡因喉部表面浸润麻醉对支撑喉镜全身麻醉手术患者心血管反应及术后躁动的影响[J].吉林医学,2017,38(11):2103.