不同剂量舒芬太尼联合异丙酚用于无抽搐电休克的临床疗效和安全性评价

发布时间：2019-02-14 09:30

【摘要】：目的比较不同剂量的舒芬太尼联合异丙酚靶控输注用于无抽搐电休克的临床疗效及安全性。方法将100例精神病患者随机分为4组:对照组(C组)、舒芬太尼1组(S1组)、舒芬太尼2组(S2组)和舒芬太尼3组(S3组),每组25例。S1~3组患者分别给予0.1,0.2,0.3μg·kg-1舒芬太尼10 m L,对照组给予等体积0.9%氯化钠。靶控输注异丙酚,设置初始靶质量浓度为3.0μg·m L-1,以质量浓度0.5μg·m L-1增加。待睫毛反射消失时,静脉注射1.0mg·kg-1琥珀胆碱,进行面罩控制呼吸后开始无抽搐电休克。记录患者麻醉前(T1)、停止靶控输注即刻(T2)、无抽搐电休克后即刻(T3)以及意识恢复时(T4)的生命体征、临床疗效、抽搐能量指数、抽搐持续时间、苏醒时间、辅助通气时间以及不良反应发生率。结果 4组患者无抽搐电休克中不同时点的生命体征、抽搐能量指数和抽搐持续时间差异无统计学意义(P0.05)。与C组比较,S2组的辅助通气时间延长,S3组的辅助通气时间及苏醒时间延长,S1~3组的临床总有效率增加(P0.05)。与S1组比较,S3组的辅助通气时间及苏醒时间延长,临床总有效率增加(P0.05)。与S2组比较,S3组的辅助通气时间延长(P0.05)。伴随舒芬太尼剂量的增加,恶心呕吐及嗜睡发生率提高,肌痛和头痛发生率降低。结论舒芬太尼联合异丙酚靶控输注的麻醉方案可以安全有效地用于无抽搐电休克,舒芬太尼以0.2μg·kg-1为佳。
[Abstract]:Objective to compare the clinical efficacy and safety of sufentanil combined with propofol target-controlled infusion in patients with no convulsive electroshock. Methods 100 psychotic patients were randomly divided into four groups: control group (group C), sufentanil group 1 (group S1), sufentanil group 2 (group S2) and sufentanil group 3 (group S3). 25 patients in each group were treated with 0.3 渭 g kg-1 sufentanil (0.1 渭 g / L) and control group (0.9% sodium chloride). The target controlled infusion of propofol was performed with the initial target concentration of 3.0 渭 g mL ~ (-1) and the concentration of 0.5 渭 g m ~ (-1) of propofol. When the eyelash reflex disappeared, 1.0mg kg-1 succinylcholine was injected intravenously. The vital signs, clinical efficacy, energy index of convulsion, duration of convulsion and recovery time were recorded before anesthesia (T1), immediately after stopping target controlled infusion (T2), immediately after no convulsive electric shock (T3) and at recovery of consciousness (T4). The duration of auxiliary ventilation and the incidence of adverse reactions. Results there was no significant difference in vital signs, tic energy index and convulsive duration between the four groups (P0.05). Compared with group C, the time of auxiliary ventilation was prolonged in group S2, the time of auxiliary ventilation and recovery was prolonged in group S3, and the total effective rate of group S1 was increased (P0.05). Compared with S1 group, the auxiliary ventilation time and recovery time of S3 group were prolonged, and the total clinical effective rate was increased (P0.05). Compared with S2 group, the auxiliary ventilation time of S 3 group was prolonged (P 0.05). With the increase of sufentanil dosage, the incidence of nausea, vomiting and lethargy increased, and the incidence of myalgia and headache decreased. Conclusion Sufentanil combined with propofol target-controlled infusion can be used safely and effectively in no convulsive electroshock. Sufentanil is better than 0.2 渭 g kg-1.
【作者单位】：河北医科大学第一医院麻醉科;
【基金】：河北省科技局卫生厅基金资助项目(09276136)
【分类号】：R614

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