氢溴酸依他佐辛对胸腔镜手术患者苏醒期躁动的影响
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摘要
目的探讨氢溴酸依他佐辛对胸腔镜手术患者苏醒期躁动的影响。方法选取择期全麻下行胸腔镜肺叶切除术患者120例,ASAⅠ或Ⅱ级。随机分为氢溴酸依他佐辛注射液组(E组)、地佐辛注射液组(D组)和氯化钠注射液组(NS组),每组40例。手术结束前15 min,E组静脉推注氢溴酸依他佐辛注射液0.3 mg·kg-1,D组静脉推注地佐辛注射液0.1 mg·kg-1,NS组静脉推注等容量0.9%氯化钠注射液。记录所有患者手术时间,苏醒时间,拔管时间及麻醉后加强病房(PACU)滞留时间。分别在苏醒即刻(t0),苏醒后10 min(t1)、20 min(t2)、30 min(t3)对患者进行Riker-镇静躁动评分,记录躁动发生率、t0～t3时患者平均动脉压(MAP)及心率(HR)。结果三组患者手术时间,苏醒时间,拔管时间及PACU滞留时间比较均差异无统计学意义(P>0.05)。与NS组比较,E组、D组在t0～t3时Riker-镇静躁动评分及术后躁动发生率均更低,两组MAP在t0～t3时也低于NS组; E组HR在t1～t3时更低,而D组HR在t2、t3时更低(P<0.05)。与D组比较,E组在t1、t2时Riker-镇静躁动评分及MAP均较低,而HR在t2时较低(P<0.05);但E、D组术后躁动发生率比较差异无统计学意义(P>0.05)。结论手术结束前15 min给予氢溴酸依他佐辛0.3 mg·kg-1能有效减少胸腔镜肺叶切除术患者苏醒期躁动的发生,同时不延长苏醒、拔管及PACU滞留时间。
Objective To investigate the effect of eptazocine hydrobromide on emergence agitation( EA) of patients undergoing video-assisted thoracoscopic surgery at recovery period. Methods One hundred and twenty patients with ASA I or II,scheduled to undergo video-assisted thoracoscopic surgery vats under general anesthesia,were randomly allocated to three groups( n = 40) : eptazocine hydrobromide injection group( group E),dezocine injection group( group D) and sodium chloride injection group( group NS). Eptazocine hydrobromide injection 0. 3 mg · kg-1,dezocine injection 0.1 mg·kg-1and sodium chloride injectionin equal volume were administrated to group E,group D and group NS,respectively,15 min before the termination of surgery. The operation time,awakening time,extubation time and postanesthesia care unit( PACU) staying time of all patients were recorded. Riker sedation-agitation scores,MAP and HR were documented at the time of awakening( t0) and10 min( t1),20 min( t2) and 30 min( t3) after awakening,and the incidence of EA was also recorded. Results There were no significant differences in operation time,awakening time,extubation time,PACU staying time among three groups( P> 0.05).Compared with the group NS,the riker sedation-agitation scores and MAP in group E and D at t0– t3 were lower,as well as the incidence of EA. HR of group E was lower at t1– t3,while HR of group D was lower at t2 and t3( P<0.05). Compared with group D,riker sedation-agitation scores and MAPs in group E were lower at t1 and t2,while HR was lower at t2( P<0.05). However,there was no difference in incidence of EA between group D and group E( P>0.05). Conclusion Administration 0.3 mg·kg-1eptazocine hydrobromide,15 min before the termination of surgery,could effectively reduce the incidence of EA in patients undergoing video-assisted thoracoscopic surgery after general anesthesia. Simultaneously,awakening time,extubation time and PACU staying time could not prolonged.
Objective To investigate the effect of eptazocine hydrobromide on emergence agitation( EA) of patients undergoing video-assisted thoracoscopic surgery at recovery period. Methods One hundred and twenty patients with ASA I or II,scheduled to undergo video-assisted thoracoscopic surgery vats under general anesthesia,were randomly allocated to three groups( n = 40) : eptazocine hydrobromide injection group( group E),dezocine injection group( group D) and sodium chloride injection group( group NS). Eptazocine hydrobromide injection 0. 3 mg · kg-1,dezocine injection 0.1 mg·kg-1and sodium chloride injectionin equal volume were administrated to group E,group D and group NS,respectively,15 min before the termination of surgery. The operation time,awakening time,extubation time and postanesthesia care unit( PACU) staying time of all patients were recorded. Riker sedation-agitation scores,MAP and HR were documented at the time of awakening( t0) and10 min( t1),20 min( t2) and 30 min( t3) after awakening,and the incidence of EA was also recorded. Results There were no significant differences in operation time,awakening time,extubation time,PACU staying time among three groups( P> 0.05).Compared with the group NS,the riker sedation-agitation scores and MAP in group E and D at t0– t3 were lower,as well as the incidence of EA. HR of group E was lower at t1– t3,while HR of group D was lower at t2 and t3( P<0.05). Compared with group D,riker sedation-agitation scores and MAPs in group E were lower at t1 and t2,while HR was lower at t2( P<0.05). However,there was no difference in incidence of EA between group D and group E( P>0.05). Conclusion Administration 0.3 mg·kg-1eptazocine hydrobromide,15 min before the termination of surgery,could effectively reduce the incidence of EA in patients undergoing video-assisted thoracoscopic surgery after general anesthesia. Simultaneously,awakening time,extubation time and PACU staying time could not prolonged.
引文
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[2]庄萍,芦滨.盐酸右美托咪定注射液对老年胸外科手术患者麻醉苏醒期的影响[J].中国药房,2017,28(11):1523-1525.
[3]丁翠青,刘志永.地佐辛超前应用对瑞芬太尼复合全身麻醉患者术后躁动的疗效分析[J].重庆医学,2016,45(5):680-682.
[4]徐美云,徐贤惠.地佐辛和布托啡诺预防全麻术后躁动的临床研究[J].中外医学研究,2015,13(34):42-43.
[5]赵峰.地佐辛联合帕瑞昔布超前镇痛对关节置换患者术后躁动的影响[J].山东医药,2015,55(28):78-79.
[6]金进宇,赵文城,彭峻松.喷他佐辛预防全麻苏醒期躁动的临床研究[J].现代预防医学,2014,41(18):3443-3447.
[7] MASOUMEH MOHKAMKAR B,FATEMEH FARHOUDI M,ALIREZA ALAMSAHEBPOUR M,et al. Postanesthetic emergence agitation in pediatric patients under general anesthesia[J].Iranian J Pediatr,2014,24(2):184-190.
[8]于带弟.地佐辛和曲马多预防小儿全麻苏醒期躁动的临床观察[J].当代医学,2014,20(1):94-96.
[9]杨晓凌,梁吉文.舒芬太尼在老年全髋关节置换术后静脉自控镇痛的临床应用[J].实用疼痛学杂志,2011,7(4):274-275.
[10]潘永英,陈柳妹,田航,等.右美托咪定对预防七氟醚复合骶管阻滞小儿麻醉苏醒期躁动的作[J].广东医学,2013,34(4):623-625.
[11]阙彬,甘建辉,史金麟,等.盐酸羟考酮用于开胸手术后自控镇痛60例[J].医药导报,2017,36(5):514-516.
[12]纪怀,黄龙,张宇浩,等.地佐辛预防鼻咽手术全麻患者术后躁动的效果[J].广东医学,2013,34(8):1277-1279.
[13]宋树叶,岳修勤.地佐辛预防全麻苏醒期患者躁动的临床观察[J].实用医学杂志,2012,28(16):2790-2791.
[14] NABESHIMA T,MATSUNO K,KAMEI H,et al.The interaction of eptazocine,a novel analgesic,with opioid receptors[J]. Res Comm Chem Pathol Pharmacol,1985,48(2):173-181.
[2]庄萍,芦滨.盐酸右美托咪定注射液对老年胸外科手术患者麻醉苏醒期的影响[J].中国药房,2017,28(11):1523-1525.
[3]丁翠青,刘志永.地佐辛超前应用对瑞芬太尼复合全身麻醉患者术后躁动的疗效分析[J].重庆医学,2016,45(5):680-682.
[4]徐美云,徐贤惠.地佐辛和布托啡诺预防全麻术后躁动的临床研究[J].中外医学研究,2015,13(34):42-43.
[5]赵峰.地佐辛联合帕瑞昔布超前镇痛对关节置换患者术后躁动的影响[J].山东医药,2015,55(28):78-79.
[6]金进宇,赵文城,彭峻松.喷他佐辛预防全麻苏醒期躁动的临床研究[J].现代预防医学,2014,41(18):3443-3447.
[7] MASOUMEH MOHKAMKAR B,FATEMEH FARHOUDI M,ALIREZA ALAMSAHEBPOUR M,et al. Postanesthetic emergence agitation in pediatric patients under general anesthesia[J].Iranian J Pediatr,2014,24(2):184-190.
[8]于带弟.地佐辛和曲马多预防小儿全麻苏醒期躁动的临床观察[J].当代医学,2014,20(1):94-96.
[9]杨晓凌,梁吉文.舒芬太尼在老年全髋关节置换术后静脉自控镇痛的临床应用[J].实用疼痛学杂志,2011,7(4):274-275.
[10]潘永英,陈柳妹,田航,等.右美托咪定对预防七氟醚复合骶管阻滞小儿麻醉苏醒期躁动的作[J].广东医学,2013,34(4):623-625.
[11]阙彬,甘建辉,史金麟,等.盐酸羟考酮用于开胸手术后自控镇痛60例[J].医药导报,2017,36(5):514-516.
[12]纪怀,黄龙,张宇浩,等.地佐辛预防鼻咽手术全麻患者术后躁动的效果[J].广东医学,2013,34(8):1277-1279.
[13]宋树叶,岳修勤.地佐辛预防全麻苏醒期患者躁动的临床观察[J].实用医学杂志,2012,28(16):2790-2791.
[14] NABESHIMA T,MATSUNO K,KAMEI H,et al.The interaction of eptazocine,a novel analgesic,with opioid receptors[J]. Res Comm Chem Pathol Pharmacol,1985,48(2):173-181.