盐酸丁丙诺啡抑制气管拨管期应激反应的作用.pdfVIP

· 270· 实用医药杂志2008年O3月第25卷第O3期 Prac J MedPharm．Vol 25。2008—03 No．03 临床研究 盐酸丁丙诺啡抑制 · 论 著· 气管拨管期应激反应的作用 吴青华 唐时荣 王 玲 张中利 胡百奇 李 澜 马 丹 (150医院麻醉科．河南洛阳 471031) I摘 要】 目的 观察盐酸丁丙诺啡对全身麻醉苏醒拔管期机体应激反应的影响。方法 60例ASA I～ Ⅱ级择期全麻下剖腹手术患者，随机分为三组。每组20例，对照组(c组)注射生理盐水；盐酸丁丙诺啡 31~g／kg组(B3组)缝皮前静脉注射31xg／kg盐酸丁丙诺啡；盐酸丁丙诺啡6txg／kg组(B6组)缝皮前静脉注射 盐酸丁丙诺啡6txg／kg。所有患者均给予异丙酚、维库溴胺、芬太尼作为仝麻诱导用药，气管插管后及手术 中微泵持续静脉注射异丙酚，间断静脉注射维库溴胺维持仝麻及肌松。分别于术前、拔管时和拔管后5min 测量血压、心率和呼吸及血氧饱和度：并对血压、呼吸、患者清醒程度、肢体运动进行评估。记录拔管时躁 动的发生率及清醒时的拔管时问。结果 c组血液动力学受影响较大。拔管时SBP和HR与术前比较有 非常显著升高 0．01)；盐酸丁丙诺啡B3组和B6组血液动力学较平稳，SBP、HR和SPO 与术前比较无 显著性差异 05)。拔管后5min各组各项指标基本恢复到术前水平。结论 盐酸丁丙诺啡能减轻全身 麻醉苏醒拔管期机体应激反应。盐酸丁丙诺啡31xg／kg静脉注射即能很好的抑制应激反应。 【关键词】盐酸丁丙诺啡 气管拔管 应激反应 【中围分类号】R614，1 【文献标识码l A The inhibition of buprenorphine on stress response indced by tracheal extubafion WU Qing-hua． TANG SHi-rong，WANG Ling，et a1．Dept．of Anesthesia，No．1 50 Hospital，Luoyang 47 1 03 1,China 【Abstract] 0bjective To observe the impact of intravenous buprenorphine on stress response induced by tracheal extubation．Methods The 60 cases of ASA I—II patients，which were scheduled for selective surgery of abdomen were randomly divided into three groups and received a standard general anesthesia consisting of fentanyl，propofol，vercuronium and isoflurane．After the operation，buprenorphine 3~g／kg (Group B3)，buprenorphine 3~g／kg (Group B6)，the normal saline (Group C)were given respectively by intravenousy injection，postoperative tracheal extubation was perfommd when acceptable criteria was achieved．Non-invasive arterial pressure(SBP)，heart rate (HR)and SPO2 were recorded before operation，as well when tracheal extubation and 5min after extubation．Results Group C was more increased when extubation than before operation in SBP，HR(尸l0．0 1)；In Group B3 and G