国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2010年
16期
2004-2007
,共4页
钱伟民%崔敬伟%杨伯梅%王福涌
錢偉民%崔敬偉%楊伯梅%王福湧
전위민%최경위%양백매%왕복용
曲马多%芬太尼%苏醒期躁动
麯馬多%芬太尼%囌醒期躁動
곡마다%분태니%소성기조동
Fentanyl%Tramadol%Restlessness%Prevention
目的 探讨芬太尼和曲马多对预防全麻后苏醒期躁动的临床效果、不良反应和安全性.方法 120例ASAⅡ级的择期腹腔镜手术患者,随机分为曲马多组(Q组)60例,其中曲马多分为1、2、3 mg/kg组(Q1、Q2、Q3组),每组20例;芬太尼组(F组)60例,其中芬太尼分为0.1、0.2、0.3μg/kg组(F1、F2、F3组),每组20例.两组病人麻醉诱导芬太尼2μg·kg-1、阿曲库铵0.5mg·kg-1、丙泊酚2mg·kg-1,麻醉维持吸入1%～3%异氟醚,丙泊酚5mg·kg-1·h-1和阿曲库铵5 mg·kg-1·h-1.术中监测收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)和呼末二氧化碳(PETCO2).术毕前30min Q1、Q2和Q3组分别缓慢静脉输入曲马多1、2和3mg/kg,F1、F2和F3组分别缓慢静脉输入芬太尼0.1、0.2和0.3μg/kg.观察拔管前、拔管时、拔管后10min各组的躁动评分(RS)、镇静评分(RSS)和意识状态评分(OAAS).观察各组用药对呼吸和循环系统的影响.结果 F组RS评分低于Q组(P＜0.05);F组OAAS评分高于Q组(P＜0.05);两组Ramsay评分差异无显著性(P＞0.05);F组患者术后躁动发生率明显低于Q组,其中F组患者中F2组优于F1组和F3组(P＜0.05).两组患者术后未见恶心、呕吐、消化道出血、严重呼吸抑制等不良反应.结论 芬太尼用于预防全麻后苏醒期躁动,效果明显优于曲马多,苏醒质量高,对呼吸、循环影响较小,可以安全用于预防全麻后苏醒期躁动.
目的 探討芬太尼和麯馬多對預防全痳後囌醒期躁動的臨床效果、不良反應和安全性.方法 120例ASAⅡ級的擇期腹腔鏡手術患者,隨機分為麯馬多組(Q組)60例,其中麯馬多分為1、2、3 mg/kg組(Q1、Q2、Q3組),每組20例;芬太尼組(F組)60例,其中芬太尼分為0.1、0.2、0.3μg/kg組(F1、F2、F3組),每組20例.兩組病人痳醉誘導芬太尼2μg·kg-1、阿麯庫銨0.5mg·kg-1、丙泊酚2mg·kg-1,痳醉維持吸入1%～3%異氟醚,丙泊酚5mg·kg-1·h-1和阿麯庫銨5 mg·kg-1·h-1.術中鑑測收縮壓(SBP)、舒張壓(DBP)、平均動脈壓(MAP)、心率(HR)、血氧飽和度(SpO2)和呼末二氧化碳(PETCO2).術畢前30min Q1、Q2和Q3組分彆緩慢靜脈輸入麯馬多1、2和3mg/kg,F1、F2和F3組分彆緩慢靜脈輸入芬太尼0.1、0.2和0.3μg/kg.觀察拔管前、拔管時、拔管後10min各組的躁動評分(RS)、鎮靜評分(RSS)和意識狀態評分(OAAS).觀察各組用藥對呼吸和循環繫統的影響.結果 F組RS評分低于Q組(P＜0.05);F組OAAS評分高于Q組(P＜0.05);兩組Ramsay評分差異無顯著性(P＞0.05);F組患者術後躁動髮生率明顯低于Q組,其中F組患者中F2組優于F1組和F3組(P＜0.05).兩組患者術後未見噁心、嘔吐、消化道齣血、嚴重呼吸抑製等不良反應.結論 芬太尼用于預防全痳後囌醒期躁動,效果明顯優于麯馬多,囌醒質量高,對呼吸、循環影響較小,可以安全用于預防全痳後囌醒期躁動.
목적 탐토분태니화곡마다대예방전마후소성기조동적림상효과、불량반응화안전성.방법 120례ASAⅡ급적택기복강경수술환자,수궤분위곡마다조(Q조)60례,기중곡마다분위1、2、3 mg/kg조(Q1、Q2、Q3조),매조20례;분태니조(F조)60례,기중분태니분위0.1、0.2、0.3μg/kg조(F1、F2、F3조),매조20례.량조병인마취유도분태니2μg·kg-1、아곡고안0.5mg·kg-1、병박분2mg·kg-1,마취유지흡입1%～3%이불미,병박분5mg·kg-1·h-1화아곡고안5 mg·kg-1·h-1.술중감측수축압(SBP)、서장압(DBP)、평균동맥압(MAP)、심솔(HR)、혈양포화도(SpO2)화호말이양화탄(PETCO2).술필전30min Q1、Q2화Q3조분별완만정맥수입곡마다1、2화3mg/kg,F1、F2화F3조분별완만정맥수입분태니0.1、0.2화0.3μg/kg.관찰발관전、발관시、발관후10min각조적조동평분(RS)、진정평분(RSS)화의식상태평분(OAAS).관찰각조용약대호흡화순배계통적영향.결과 F조RS평분저우Q조(P＜0.05);F조OAAS평분고우Q조(P＜0.05);량조Ramsay평분차이무현저성(P＞0.05);F조환자술후조동발생솔명현저우Q조,기중F조환자중F2조우우F1조화F3조(P＜0.05).량조환자술후미견악심、구토、소화도출혈、엄중호흡억제등불량반응.결론 분태니용우예방전마후소성기조동,효과명현우우곡마다,소성질량고,대호흡、순배영향교소,가이안전용우예방전마후소성기조동.
Objective To explore the effects of fentanyl and tramadol on restlessness during consciousness phase after remifentanil-based general anesthesia. Methods 120 ASA II patients undergo- ing elective laparoscopic surgery under general anesthesia were randomly assigned to group Q1, Q2, Q3, F1, F2, or F3 with 20 each. 30 min before the end of the procedure, tramadol of 1, 2, or 3 mg/kg was administered to group Q1, Q2, or Q3. so was fentanyl of 0.1, 0.2, or 0.3 μ,/kg to groups F1, F2, and F3. SBP, DBP, MAP, HR, SpO2, and PftCO2 were recorded. Restlessness Score (RS), Ramsay Sedation Score (RSS), Observer's Assessment of Alertness/Sedation Score (OAAS) were recorded before, during, and 10 min after extubation. Body side reaction were observed. Results RS was apparently higher in groups Q1 and Q2 than in group Q3 before, (luring, and 10 min after extuhation (P<0.05). RS in group Q1 was apparently higher than that in groups F1, F2. and F3(P<0.05). RSS in groups Q1 and Q2 was apparently higher than that in group Q3 before, during, and 10 min after extuhation ({<0.05). RSS in groups Q1, Q2. and Q3 was apparently higher than that in groups F1, F2, and F3 (P<0.05). OASS in groups Q1 and Q2 was apparently higher than that in group Q3 before, during, and 10 min after extubation (P<0.05). OASS in group Q3 was apparently higher than that in groups F1, F2, and F3 (P<0.05). The major side effects in group F3 were respiratory depression and circulatory system. Conclusions Application of 0.3 μ g/kg fentany can safely and perfectly prevent restlessness during consciousness phase after remifentanil-based general anesthesia, and has fewer side effects.
