羟考酮用于全麻诱导时对患者血流动力学及应激反应的影响

发布时间：2018-03-28 02:22

本文选题：羟考酮　切入点：舒芬太尼　出处：《实用医学杂志》2017年16期

【摘要】：目的观察等效剂量的羟考酮和舒芬太尼用于全麻诱导时对患者血流动力学及应激反应的影响。方法 120例腹部手术患者分为羟考酮组(O组)和舒芬太尼组(S组),每组60例。全麻诱导:O组静注丙泊酚2.0~2.5 mg/kg、顺式阿曲库铵0.25 mg/kg、羟考酮0.25 mg/kg;S组静注舒芬太尼0.25μg/kg,其余用药及给药顺序同O组。诱导后两组均插入单腔气管导管。记录诱导前(T_0)、插管前即刻(T_1)、插管即刻(T_2)、插管后1 min(T_3)、插管后5 min(T_4)平均动脉压(MAP)、心率(HR)的变化。测定T_0、T_2、T_3、T_4各时点血浆肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(Cor)及血糖(Glu)的数值。记录两组诱导期间发生呛咳的比例。结果与T0相比,(1)两组T1MAP及HR均明显降低(P0.05),两组相比无显著性差异(P0.05)。(2)两组T_2,T_3MAP及HR有明显升高(P0.05),两组相比亦有显著性差异(P0.05)。(3)两组T_4MAP及HR有所升高,但无显著性差异,两组相比亦无显著性差异(P0.05)。(4)在T_2、T_3,两组E、NE、Cor、Glu均明显增高(P0.05),两组相比有显著性差异(P0.05)。在T_4,两组的E、NE、Cor、Glu均有增高,但无明显差异(P0.05),两组相比亦无显著性差异(P0.05)。结论静脉注射等效剂量的羟考酮和舒芬太尼行全麻诱导,羟考酮可以更有效维持血流动力学平稳,降低应激反应的发生。
[Abstract]:Objective to observe the effects of the equivalent doses of hydroxycodone and sufentanil on hemodynamics and stress response in patients undergoing general anesthesia induction. Methods 120 patients undergoing abdominal surgery were divided into two groups: hydroxone group (n = 20) and sufentanil group (group S). 60 patients in each group were given intravenous injection of propofol 2.0 mg / kg, cis atracurium 0.25 mg / kg, hydroxycodone 0.25 mg / kg / kg by intravenous injection of sufentanil 0.25 渭 g / kg / kg, the rest in the same order as O group. After induction, the two groups were inserted into a single lumen tracheal catheter. The changes of mean arterial pressure (MAPV) and heart rate (HR-HRV) were observed at 1 min after intubation, 1 min after intubation and 5 min after intubation. The plasma levels of epinephrine, norepinephrine, norepinephrine (NE), cortisone cortisone (Corn) and blood glucose (Glux) were measured at each time point before T0 / T _ 0, T _ (2) and T _ (3) T _ (4). Results compared with T0, the T1MAP and HR of the two groups were significantly lower than that of the T0 group, but there was no significant difference between the two groups. However, there was no significant difference between the two groups, and there was no significant difference between the two groups (P 0.05). There was no significant difference between the two groups. There was no significant difference between the two groups in the number of Glu in the two groups and in the two groups, there was a significant difference between the two groups (P 0.05). In the two groups, the level of Glu in the two groups was higher than that in the two groups, and the level of Glu in the two groups was higher than that in the other two groups, and the level of Glu in the two groups was higher than that in the other two groups. But there was no significant difference between the two groups (P 0.05), and there was no significant difference between the two groups. Conclusion intravenous administration of equivalent doses of hydroxycodone and sufentanil can effectively maintain hemodynamic stability and reduce stress response.
【作者单位】：郑州大学附属肿瘤医院麻醉科;
【基金】：河南省科技攻关计划项目(编号:162102310337)
【分类号】：R614

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