胸腔镜肺叶切除术患者麻醉诱导前及手术结束时静注纳美芬临床观察

发布时间：2018-05-12 19:43

本文选题：胸腔镜肺叶切除术 + 纳美芬　；参考：《山东医药》2017年31期

【摘要】：目的观察胸腔镜肺叶切除术患者麻醉诱导前2 min及手术结束时静注纳美芬的临床效果。方法 80例择期行胸腔镜肺叶切除术患者随机分为I+A组、I组、A组、C组各20例,I+A组麻醉诱导前2 min及手术结束时均静注纳美芬0.15μg/kg,I组于麻醉诱导前2 min静注纳美芬0.15μg/kg,A组于手术结束时静注纳美芬0.15μg/kg,C组静注与I+A组等量生理盐水。观察各组快速推入舒芬太尼诱导时呛咳反应发生率,记录各组麻醉诱导前(T0)、插管时(T_1)、插管后5 min(T_2)、拔管时(T_3)、拔管后10 min(T_4)的MAP、HR、SpO_2,比较各组拔管时间、拔管后10 min Ramsay评分、VSA评分。结果 I+A组发生呛咳1例(5%),I组为0例,A组为7例(35%),C组为8例(40%),I+A组、I组分别与A组、C组比较,P均0.05。与A组、C组比较,I+A组和I组T_1时点MAP、HR降低(P均0.05);与I组、C组比较,I+A组和A组T_3时点MAP、HR降低(P均0.05);与同组T0时点比较,I+A组T_1~T_4时点SpO_2降低,I组T_3时点MAP、HR及T_1~T_3时点SpO_2升高,A组T_1时点MAP、HR升高及T_1~T_4时点SpO_2降低,C组T_3时点MAP及T_1、T_3、T_4时点HR升高和T_2~T_4时点SpO_2降低,P均0.05。与I组、C组比较,I+A组和A组拔管时间短、Ramsay评分高(P均0.05)。结论全麻诱导前2 min及手术结束时静注小剂量纳美芬,可以降低插管期呛咳反应发生率,有利于维持麻醉诱导和手术结束时血流动力学平稳,缩短患者苏醒时间和拔管时间。
[Abstract]:Objective to observe the clinical effect of intravenous namefen in patients undergoing thoracoscopic lobectomy 2 min before anesthesia induction and at the end of operation. Methods 80 patients undergoing selective thoracoscopic lobectomy were randomly divided into two groups: group I (n = 20), group A (n = 20) before induction of anesthesia, and group A (n = 20), who were given namifen 0.15 渭 g / kg / kg intravenously at the end of operation before anesthesia induction. Group A (0.15 渭 g 路kg ~ (-1) 路min ~ (-1) was given the same amount of normal saline as group I (n = 15) at the end of operation. To observe the incidence of choking cough reaction induced by sufentanil in each group, and to record the time of extubation, the time of extubation and the scores of 10 min Ramsay after extubation and the scores of VSA in each group, 5 minutes after intubation, 5 minutes after intubation, 20 minutes after extubation, 10 minutes after extubation, and 10 minutes after extubation. Results 1 case of choking cough occurred in group I, 0 cases in group A, 7 cases in group C, 8 cases in group A and 8 cases in group I, respectively, compared with group A, group C and group A (P < 0.05). Compared with group A, group A and group I, group I and group I, compared with group C, group I, group C, group A, group T 3, the levels of SpO_2 at time of SpO_2 decrease at time of T3 and T_1~T_3 in group I, group A, and group A, respectively, compared with those in group A and group C, the levels of MAPHR in group I and group I were lower than those in group A and group I, and in group I, group A and group A, compared with those in group I, group C and group A, respectively. In group A, SpO_2 increased at time 1 and SpO_2 decreased at time of T_1~T_4. In group C, MAP increased at time 3 and MAP increased at time point T4 and SpO_2 at time of T_2~T_4 decreased by 0.05 in group T _ (1) and T _ (3) T _ (4). Compared with group I, group C, group I and group A had shorter extubation time and higher Ramsay score (P < 0.05). Conclusion 2 min before induction of general anesthesia and intravenous injection of namefen at the end of operation can reduce the incidence of cough choking during intubation, which is beneficial to maintain stable hemodynamics and shorten the recovery time and extubation time of the patients during anesthesia induction and operation.
【作者单位】：武汉大学中南医院;
【基金】：湖北省卫生计生委创新团队项目(WJ2017M036)
【分类号】：R614

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