摘要
目的舒芬太尼、氟比洛芬酯对在丙泊酚深度镇静下气管拔管期间应激反应及苏醒质量的影响。方法 60例全麻患者随机分为舒芬太尼组(SF组)和氟比洛芬酯组(FL组)两组。手术结束前30min分别静注舒芬太尼0.2μg/kg,氟比洛芬酯1mg/kg,丙泊酚以5mg/(kg.h)持续泵注至拔管即刻。记录停肌松剂至自主呼吸恢复、手术结束至拔管、拔管至苏醒、手术结束至离室时间及拔管前(T0)、拔管时即刻(T1)、拔管后5min(T2)、拔管后10min(T3)时点的HR、MAP、SpO2、PETCO2、AAI、血糖的变化,RSS镇静评分、RS躁动评分及不良反应。结果①在相同时间T1时,FL组HR、MAP、血糖均高于SF组(P<0.05)。FL组T1时的HR明显高于T0时(P<0.05)。两组T1时的血糖均明显高于T0时(P<0.05)。②T1、T2、T3时,FL组AAI明显高于SF组(P<0.05),T2时FL组RSS高于SF组(P<0.05),T1时FL组RS高于SF组(P<0.05)。③两组病人恢复时间及不良反应无明显差异(P>0.05)。结论舒芬太尼、氟比洛芬酯在丙泊酚深度镇静下气管拔管,均能不同程度抑制拔管期间呛咳和心血管应激反应,减少拔管后的焦虑和躁动,舒芬太尼效果更佳。
【Objective】 To study the effect of sufentanyl and flurbiprofen on stress reaction and quality of consciousness recovery during tracheal extubation under deep sedation induced by propofol.【Method】 60 patients under general anesthesia were randomly divided into two groups： sufentanyl group（group SF,n =30） and flurbiprofen group（group FL,n =30）.0.2 μg/kg of sufentanyl and 1 mg/kg of flurbiprofen were injected intravenously in the two groups respectively 30 min before the end of operation.5 mg/（kg·h） of propofol was pump-infusing until extubation.The time ranges from cessation of muscle relaxants to recovery of autonomous respiration,from the end of operation to extubation,from extubation to consciousness and from the end of operation to the time of leaving operation room was recorded.The changes of HR,MAP,SpO2,PETCO2,blood glucose（Glu）,value of AAI before extubation（T0）,during extubation（T1）,5 min after extubation（T2）,10 min after extubation（T3） were recorded as well.Meanwhile,ramsay sedation scale（RSS）,restlessness score（RS）,the incidence of glossocoma,respiratory depression,restlessness,hypersomnia and nausea and vomiting were observed respectively at the same time point.【Results】 ①At T1,heart rate,MAP and Glu were significantly higher in group FL than group SF（P〈0.05）;within group FL,HR at T1 was higher than T0;Glu at T1 was higher than T0 within both groups significantly（P〈0.05）.②AAI at T1,T2 and T3 in group FL was significantly higher than group SF（P〈0.05）.RSS at T2 in group FL was significantly higher than group SF（P〈0.05）.RS at T1 in group FL was higher than group SF（P〈0.05）.③There was no significant difference in recovery time and the incidence of adverse effect between group FL and SF（P〈0.05）.【Conclusion】 Sufentanyl and flurbiprofen,which are used during tracheal extubation under deep sedation induced by propofol,could suppress bucking and cardiovascular stress response during extubation with different extent,and could reduce anxiety and restlessness after extubation.This method which is safe and feasible can improve the quality of consciousness recovery,sufentanyl is more effectual.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2012年第7期34-38,共5页
China Journal of Modern Medicine
基金
贵州省卫生厅科技基金(No:D-294)
关键词
镇静
气管拔管
丙泊酚
舒芬太尼
氟比洛芬酯
应激
sedation
tracheal extubation
propofol
sufentanyl
flurbiprofen
stress response
