羟考酮与舒芬太尼用于腹腔镜胆囊切除术麻醉诱导的效果比较

发布时间：2018-05-28 07:56

本文选题：羟考酮 + 舒芬太尼　；参考：《中国内镜杂志》2017年08期

【摘要】：目的比较盐酸羟考酮与枸橼酸舒芬太尼用于腹腔镜胆囊切除术(LC)麻醉诱导的麻醉及镇痛效果。方法择期LC术患者60例,美国麻醉医师协会分级(ASA)Ⅰ或Ⅱ级,采用随机数字表法分为两组:羟考酮组(O组)及舒芬太尼组(S组)。麻醉诱导:O组:静脉注射丙泊酚1.0~2.0 mg/kg、羟考酮0.3 mg/kg、维库溴铵0.1 mg/kg;S组:静脉注射丙泊酚1.0~2.0 mg/kg、舒芬太尼0.3μg/kg、维库溴铵0.1 mg/kg。麻醉维持采用常用的静吸复合药物。记录入手术室后(T0)、麻醉诱导后置入喉罩前(T1)、麻醉诱导置入喉罩后1 min(T2)、建立人工气腹后(T3)、分离胆囊时(T4)、苏醒即刻(T5)和离开复苏室即刻(T6)时的心率(HR)、收缩压(SBP)、舒张压(DBP),记录苏醒即刻(T5)、离开复苏室即刻(T6)、术后4 h(T7)、术后8 h(T8)和术后第1天(T9)的疼痛数字等级评分(NRS),记录苏醒时间及术毕患者复苏过程中追加止痛药例数,观察术后患者不良反应情况。结果两组患者术中平均HR、SBP及DBP波动不超过基础值的20.0%。两组患者术毕苏醒时间无明显差异。S组苏醒后补救镇痛的比率为36.7%,较O组更多(P=0.040)。O组较S组在T5、T7、T8和T9等时间点疼痛NRS评分更低,但是差异无统计学意义。两组患者不良反应情况比较无明显差异。结论 0.3 mg/kg羟考酮与舒芬太尼0.3μg/kg用于LC手术麻醉诱导,患者麻醉及镇痛效果良好,能满足临床麻醉及术后镇痛需求。0.3 mg/kg的羟考酮有与0.3μg/kg的舒芬太尼相当或更好的镇痛作用。
[Abstract]:Objective to compare the anesthetic and analgesic effects of oxycodone hydrochloric oxycodone and sufentanil for laparoscopic cholecystectomy (LC). Methods 60 patients with selected LC, American anesthesiologist's classification (ASA) I or II were divided into two groups: hydroxyketone group (group O) and sufentanil group (group S). Anesthesia induction: group O: Intravenous propofol 1.0~2.0 mg/kg, oxycodone 0.3 mg/kg, vecuronium 0.1 mg/kg; S group: intravenous propofol 1.0~2.0 mg/kg, sufentanil 0.3 u g/kg, vecuronium 0.1 mg/kg. anesthesia to maintain the use of common inhalation compound drugs. Records into the operation room (T0), anesthesia induction into the laryngeal mask (T1), anesthesia induction of the laryngeal mask 1 min after inducement of the laryngeal mask after inducement of the laryngeal mask after the 1 min. (T2), after the establishment of the artificial pneumoperitoneum (T3), the separation of the gallbladder (T4), the awakening of the heart rate (HR), the systolic pressure (SBP), the diastolic pressure (DBP), the recording of the immediate (T5), the immediate (T6), the 4 h (T7) after the operation, the postoperative 8, and the first day after the operation, to record the awakening time and the postoperation. In the process of resuscitation, the number of analgesics was added and the adverse reactions were observed. Results the average HR, SBP and DBP fluctuations in the two groups were not more than the base value of the 20.0%. two. The rate of recovery after the recovery was 36.7% in the.S group and in the O group (P=0.040).O group compared with the S group in T5, T7, T8, and others. The time point pain NRS score was lower, but the difference was not statistically significant. There was no significant difference in the adverse reaction between the two groups. Conclusion 0.3 mg/kg oxycodone and sufentanil 0.3 mu g/kg were used for LC anesthesia induction, and the anesthesia and analgesic effect of the patients was good, and the oxycodone, which could meet the clinical anesthesia and postoperative analgesic needs, was with 0.3 mu. G/kg's sufentanil has a considerable or better analgesic effect.
【作者单位】：浙江大学金华医院(金华市中心医院)麻醉科;
【分类号】：R614

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