不同剂量羟考酮在肺癌胸腔镜手术全身麻醉诱导气管插管中的应用

发布时间：2018-06-17 14:36

本文选题：羟考酮 + 麻醉药　；参考：《中国现代手术学杂志》2016年04期

【摘要】：目的研究肺癌胸腔镜手术全身麻醉诱导气管插管下羟考酮的应用剂量及其对应激反应的影响。方法选择2014年11月至2016年1月我院胸外科收治行肺癌胸腔镜手术的81例患者为研究对象。随机分为三组,每组27例。麻醉诱导:静脉注射咪达唑仑0.05 mg/kg、异丙酚1.5 mg/kg和顺阿曲库铵0.8 mg/kg,A、B、C组分别静脉注射羟考酮0.25 mg/kg、0.35 mg/kg和0.45 mg/kg。双腔支气管导管插管后行机械通气。别于麻醉诱导前(T0)、气管插管前即刻(T1)、气管插管后即刻(T2)、气管插管后1 min(T3)和气管插管后5 min(T4)时采集外周静脉血样,采用高效液相色谱法测定血清去甲肾上腺素(norepinephrine,NE)和肾上腺素(epinephrine,E)的浓度。结果研究发现,与T1比较,A组T2、T3时血清NE和E浓度升高(P0.05);与A组比较,B组和C组T2、T3时血清NE和E浓度降低(P0.05)。B组和C组的不良反应显著低于A组(P0.05),B组和C组的不良反应比较差异无统计学意义(P0.05),但B组更低。结论羟考酮抑制单肺通气患者双腔支气管导管插管反应的适宜剂量为0.35 mg/kg。
[Abstract]:Objective to study the dose of hydroxycodone and its effect on stress response in tracheal intubation induced by general anesthesia in patients with lung cancer undergoing thoracoscopic surgery. Methods from November 2014 to January 2016, 81 patients with lung cancer underwent thoracoscopic surgery in our hospital. They were randomly divided into three groups with 27 cases in each group. Anesthesia induction: intravenous midazolam 0.05 mg / kg, propofol 1.5 mg/kg and cisatracurium 0.8 mg / kg ~ (-1) / kg ~ (-1) were injected intravenously with hydroxycodone 0.25 mg / kg / kg 0.35 mg/kg and 0.45 mg 路kg ~ (-1) 路kg ~ (-1) respectively. Mechanical ventilation was performed after double lumen bronchial catheter intubation. Blood samples of peripheral veins were collected before anesthesia induction, immediately before tracheal intubation, immediately after tracheal intubation, 1 min after tracheal intubation and 5 min after tracheal intubation. The concentrations of norepinephrineine (NE) and epinephrine (E) in serum were determined by high performance liquid chromatography (HPLC). As a result, the study found that Compared with T1, the levels of serum NE and E in group A were higher than those in group A, and the levels of NE and E in group B and group C were lower than those in group A and group C respectively. The adverse reactions in group B and C were significantly lower than those in group A and group C, respectively. There was no significant difference in adverse reactions between group A and group C. P 0.05, but lower in group B. Conclusion the appropriate dose of hydroxycodone for inhibiting the intubation response of double lumen bronchial catheter in patients with single lung ventilation is 0.35 mg / kg.
【作者单位】：南京市胸科医院麻醉科;
【分类号】：R614.2;R734.2

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