纳美芬在人工流产舒芬太尼复合丙泊酚麻醉中的应用

发布时间：2018-03-07 02:18

本文选题：流产　切入点：人工　出处：《实用医学杂志》2015年13期 　论文类型：期刊论文

【摘要】：目的:探讨纳美芬用于人工流产舒芬太尼复合丙泊酚麻醉中的疗效及其对BIS值的影响。方法:120例接受人工流产手术患者,随机分为A、B、C、D四组(n=30):A、B组分别予舒芬太尼0.2μg/kg、0.3μg/kg后复合丙泊酚1.5 mg/kg诱导麻醉;C、D组麻醉前静注纳美芬0.2μg/kg后分别同A、B组进行诱导。根据BIS值及血流动力学的波动来调整丙泊酚的用量,必要时单次静脉追加丙泊酚0.5 mg/kg。观察并记录患者注药前(T1)、睫毛反射消失时(T2)、扩宫(T3)、人流手术操作(T4)、术毕清醒时(T5)等时刻的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(Sp O2)和呼吸频率(RR),同时记录各组丙泊酚追加量、手术时间、术毕苏醒时间、术毕1 min定向力恢复Steward评分、术中体动反应、呛咳、呼吸抑制等不良反应发生率、术后15 min视觉模拟数字评分(VAS)等。结果:与A组比较,B、D组丙泊酚追加量减少,术中体动反应发生率低,术后VAS低(P0.05),C组与A组无明显差异(P0.05);B、C、D组苏醒快,术毕1 min内定向力恢复较A组评分高(P0.05),其中D组定向力恢复评分明显高于B组(P0.05);A、B组呼吸抑制及呛咳发生率高于C、D组(P0.05)。结论:术前使用纳美芬0.2μg/kg可有效拮抗无痛人流中舒芬太尼引起的呼吸抑制、苏醒延迟等不良反应,该剂量在本研究中未观察到增强镇痛的效果,未发现其影响BIS的改变。
[Abstract]:Objective: to investigate the effect of namefen on the anesthesia of sufentanil combined with propofol in induced abortion. The dosage of propofol was adjusted according to the fluctuation of BIS value and hemodynamics, and the dosage of propofol was adjusted according to the fluctuation of BIS value and hemodynamics, and the dosage of propofol was adjusted according to the fluctuation of BIS value and hemodynamics, and the dosage of propofol was adjusted according to the fluctuation of BIS value and hemodynamics, and the dosage of propofol was adjusted according to the fluctuation of BIS value and hemodynamics, and the dosage of propofol was adjusted according to the fluctuation of BIS value and hemodynamics. When necessary, propofol 0.5 mg / kg was added to the vein. The mean arterial pressure (MAPP), heart rate (HRR) and pulse oxygen saturation (Sp) were observed and recorded before the injection of propofol, T _ 2, T _ 3, T _ 4, T _ 4 and T _ 5) when the eyelash reflex disappeared. O2) and the respiratory frequency of RRN, and recorded the supplemental dose of propofol in each group. The time of operation, the time of waking up after operation, the recovery of Steward score at 1 min orientation, the incidence of adverse reactions such as body movement, cough, respiratory inhibition, etc. Results: compared with group A, the supplementary dose of propofol was decreased and the incidence of intraoperative systemic motility was lower in group B than in group A. there was no significant difference between group C and group A in postoperative VAS and group A in the recovery of propofol, and the recovery of propofol in group C was faster than that in group A. The recovery of internal orientation in group D was significantly higher than that in group A at 1 min after operation, and the recovery score of directional force in group D was significantly higher than that in group B (P 0.05). The incidence of respiratory depression and cough in group B was higher than that in group C D (P 0.05). Conclusion: nalmefen 0.2 渭 g / kg before operation can effectively antagonize painless patients. Respiratory inhibition caused by sufentanil in the stream, Adverse effects such as delayed recovery were not observed in this study and no effect on BIS was observed.
【作者单位】：南方医科大学第三临床医学院;南方医科大学附属广东省第二人民医院;广东省第二人民医院;
【基金】：广东省2010年度适宜卫生技术推广项目(编号:粤卫【2010】152号)
【分类号】：R169.42

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