应用纳美芬与纳洛酮对新生儿腹腔镜幽门环切术后苏醒的作用研究

发布时间：2018-08-10 19:29

【摘要】：目的观察纳美芬对新生儿腹腔镜幽门环切术后苏醒的临床效果。方法择期气管插管吸入麻醉下腹腔镜幽门环切术新生儿60例,年龄15~28 d,美国麻醉医师协会(ASA)Ⅱ~Ⅲ级,随机分为纳美芬组(M组)和纳洛酮组(L组),每组30例。手术结束时M组静脉注射纳美芬0.25μg/kg,L组静脉注射纳洛酮1.00μg/kg。并记录静脉注射纳美芬或纳洛酮前(T_0)、给药后10 min(T_1)、拔管后30 min(T_2)和拔管后2 h(T_3)的脉搏血氧饱和度(SpO_2)、平均动脉压(MAP)、心率(HR)和呼吸频率(RR);记录自主呼吸恢复时间、拔管时间、麻醉后监测治疗室(PACU)停留时间及手术结束后24 h内不良反应(如呼吸抑制、恶心呕吐、嗜睡和躁动等)。结果两组在T_0、T_1、T_2和T_3时点,SpO_2、MAP和HR比较均差异无统计学意义(P0.05),两组患儿T_1、T_2和T_3时的RR,均较T_0时明显升高(P0.05),且T_1时,M组RR明显快于L组(P0.05)。M组患儿自主呼吸恢复时间、拔管时间和PACU停留时间差均明显短于L组(P0.05)。术后不良反应差异无统计学意义。结论纳美芬在合理剂量范围内,有助于新生儿腹腔镜幽门环切术后早期苏醒。和纳络酮相比,可有效缩短拔管时间,促进早期恢复。
[Abstract]:Objective to observe the clinical effect of namefen on the recovery of neonates after laparoscopic pylorectomy. Methods 60 neonates with laparoscopic pylorectomy under tracheal intubation anesthesia, aged 1528 days, were randomly divided into two groups (group M, n = 30) and naloxone group (n = 30, n = 30). At the end of operation, naloxone was injected intravenously in group M with naloxone at a dose of 0.25 渭 g / kg 路kg ~ (-1) 路kg ~ (-1). The pulse oxygen saturation (SpO_2) at 10 min (T _ 1), 30 min (T _ 2) and 2 h after extubation (T _ 3), mean arterial pressure (MAP), heart rate (HR) and respiratory rate (RR);) were recorded before intravenous injection of naloxone or naloxone (T0), 10 min after administration (T _ 1), 30 min (T _ 2) after extubation and 2 h (T _ 3) after extubation. The duration of (PACU) stay in the treatment room and adverse reactions (such as respiratory depression, nausea and vomiting, lethargy and restlessness) were monitored after anesthesia. Results there was no significant difference in SPO2MAP and HR between the two groups at the time point of T0 / T _ (1) and T _ (3) (P0.05). The RRs at T _ (1) and T _ (2) and T _ (3) in two groups were significantly higher than those at T _ (0) (P0.05), and the RR of group M was significantly faster than that of group L (P 0.05) .The time of recovery of spontaneous respiration in group T _ (1) and T _ (3) was significantly higher than that in group T _ (1) and T _ (3) (P < 0.05). The difference between extubation time and PACU stay time was significantly shorter than that in L group (P0.05). There was no significant difference in postoperative adverse reactions. Conclusion nalmefen is helpful to early recovery of neonates after laparoscopic pylorectomy within a reasonable dose range. Compared with naloxone, it can shorten extubation time and promote early recovery.
【作者单位】：南京医科大学附属儿童医院麻醉科;
【分类号】：R726.1

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