国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2014年
11期
995-998
,共4页
杜真%张溪英%朱诗利%吴畏%王江平
杜真%張溪英%硃詩利%吳畏%王江平
두진%장계영%주시리%오외%왕강평
纳美芬%先天性心脏病%呼吸抑制
納美芬%先天性心髒病%呼吸抑製
납미분%선천성심장병%호흡억제
Nalmefene%Congenital heart disease%Postoperative respiratory depression
目的 评价纳美芬拮抗先天性心脏病(先心病)患儿术后阿片类药物所致呼吸抑制的效果.方法 选择行先心病择期手术的患儿60例,采用随机数字表法分为3组(每组20例):对照组(C组)、Ⅰ组、Ⅱ组.手术结束后,患儿带管送入胸外科重症监护室,待生命体征平稳10 min后:C组(对照组)不给予任何拮抗药;Ⅰ组静脉注射纳美芬0.25 μg/kg;Ⅱ组静脉注射纳美芬0.25μg/kg,观察5 min,再次静脉注射纳美芬0.25μg/kg.记录给药前即刻(T1)、给药后5 min(T2)、给药后30 min(T3)、呼吸恢复时(T4)、拔管时(T5)、拔管后1 h(T6)、拔管后3 h(T7)患儿的平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)、脉搏血氧饱和度(pulse oxygen saturation,SpO2)和血气分析结果,记录患儿的呼吸恢复时间、拔管时间及心脏病加强监护病房(cardiac intensive care unit,CICU)监护时间,并观察术后恶心、呕吐、发热、躁动、伤口疼痛等副作用的发生率.结果 C组患儿术后呼吸恢复时间、气管导管拔出时间和CICU监护时间分别为(2.9±1.0)、(3.6±1.4)、(18.5±5.8)h,Ⅰ组分别为(1.8±0.6)、(2.3±0.6)、(8.2±3.1)h,Ⅱ组分别为(1.7±0.5)、(2.1±0.7)、(7.9±2.9)h;与C组比较,Ⅰ组和Ⅱ组的各时间均缩短(P＜0.05).C组患儿术后恶心、呕吐的发生率为15％,Ⅰ组和Ⅱ组的发生率降低,分别为5％和0(P＜0.05).结论 纳美芬可安全有效地拮抗先心病手术患儿术后阿片类药物所致呼吸抑制作用,且能减少术后副作用发生率.
目的 評價納美芬拮抗先天性心髒病(先心病)患兒術後阿片類藥物所緻呼吸抑製的效果.方法 選擇行先心病擇期手術的患兒60例,採用隨機數字錶法分為3組(每組20例):對照組(C組)、Ⅰ組、Ⅱ組.手術結束後,患兒帶管送入胸外科重癥鑑護室,待生命體徵平穩10 min後:C組(對照組)不給予任何拮抗藥;Ⅰ組靜脈註射納美芬0.25 μg/kg;Ⅱ組靜脈註射納美芬0.25μg/kg,觀察5 min,再次靜脈註射納美芬0.25μg/kg.記錄給藥前即刻(T1)、給藥後5 min(T2)、給藥後30 min(T3)、呼吸恢複時(T4)、拔管時(T5)、拔管後1 h(T6)、拔管後3 h(T7)患兒的平均動脈壓(mean arterial pressure,MAP)、心率(heart rate,HR)、脈搏血氧飽和度(pulse oxygen saturation,SpO2)和血氣分析結果,記錄患兒的呼吸恢複時間、拔管時間及心髒病加彊鑑護病房(cardiac intensive care unit,CICU)鑑護時間,併觀察術後噁心、嘔吐、髮熱、躁動、傷口疼痛等副作用的髮生率.結果 C組患兒術後呼吸恢複時間、氣管導管拔齣時間和CICU鑑護時間分彆為(2.9±1.0)、(3.6±1.4)、(18.5±5.8)h,Ⅰ組分彆為(1.8±0.6)、(2.3±0.6)、(8.2±3.1)h,Ⅱ組分彆為(1.7±0.5)、(2.1±0.7)、(7.9±2.9)h;與C組比較,Ⅰ組和Ⅱ組的各時間均縮短(P＜0.05).C組患兒術後噁心、嘔吐的髮生率為15％,Ⅰ組和Ⅱ組的髮生率降低,分彆為5％和0(P＜0.05).結論 納美芬可安全有效地拮抗先心病手術患兒術後阿片類藥物所緻呼吸抑製作用,且能減少術後副作用髮生率.
목적 평개납미분길항선천성심장병(선심병)환인술후아편류약물소치호흡억제적효과.방법 선택행선심병택기수술적환인60례,채용수궤수자표법분위3조(매조20례):대조조(C조)、Ⅰ조、Ⅱ조.수술결속후,환인대관송입흉외과중증감호실,대생명체정평은10 min후:C조(대조조)불급여임하길항약;Ⅰ조정맥주사납미분0.25 μg/kg;Ⅱ조정맥주사납미분0.25μg/kg,관찰5 min,재차정맥주사납미분0.25μg/kg.기록급약전즉각(T1)、급약후5 min(T2)、급약후30 min(T3)、호흡회복시(T4)、발관시(T5)、발관후1 h(T6)、발관후3 h(T7)환인적평균동맥압(mean arterial pressure,MAP)、심솔(heart rate,HR)、맥박혈양포화도(pulse oxygen saturation,SpO2)화혈기분석결과,기록환인적호흡회복시간、발관시간급심장병가강감호병방(cardiac intensive care unit,CICU)감호시간,병관찰술후악심、구토、발열、조동、상구동통등부작용적발생솔.결과 C조환인술후호흡회복시간、기관도관발출시간화CICU감호시간분별위(2.9±1.0)、(3.6±1.4)、(18.5±5.8)h,Ⅰ조분별위(1.8±0.6)、(2.3±0.6)、(8.2±3.1)h,Ⅱ조분별위(1.7±0.5)、(2.1±0.7)、(7.9±2.9)h;여C조비교,Ⅰ조화Ⅱ조적각시간균축단(P＜0.05).C조환인술후악심、구토적발생솔위15％,Ⅰ조화Ⅱ조적발생솔강저,분별위5％화0(P＜0.05).결론 납미분가안전유효지길항선심병수술환인술후아편류약물소치호흡억제작용,차능감소술후부작용발생솔.
Objective To evaluate the efficacy of nalmefene antagonizing postoperative respiratory depression in children with congenital heart disease.Methods Sixty ASA Ⅰ or Ⅱ children,aged 3 y-6 y and undergoing congenital heart disease surgery,were included and randomly divided into 3 groups (n=20).All the patients were sent into the cardiac intensive care unit (CICU) after surgery.At 10 min following the patients' vital sign was stable in the CICU,patients in group Ⅰ were administered intravenously with nalmefene 0.25 μg/kg and group Ⅱ were injected intravenously with nalmefene 0.25 μg/kg twice.Patients in group C were not given drug (control group).Mean arterial pressure(MBP),heart rate(HR),pulse oxygen saturation(SpO2) and blood gas analysis before and after administration,during respiratory recovery,duration of extubation,duration of monitoring in the CICU,and adverse effects including nausea,vomiting,fever,restlessness and wound pain were observed.Results Duration of respiratory recovery,extubation,and monitoring in the CICU were (2.9±1.0),(3.6± 1.4) h and (18.5±5.8) h in group C,respectively,(1.8± 0.6),(2.3±0.6) h and(8.2±3.1) h in group Ⅰ,(1.7±0.5),(2.1±0.7) h and (7.9±2.9) h in group Ⅱ.Duration of respiratory recovery,extubation,and monitoring in the CICU were significantly shorter in groups Ⅰ and Ⅱ than in control group (P＜0.05).Incidence of postoperative nausea and vomiting was 15％,5％ and 0％ in groups C,Ⅰ and Ⅱ,respectively,with a lower incidence of postoperative nausea and vomiting in groups Ⅰ and Ⅱ than in group C (P＜0.05).Conclusions Nalmefene is effective and safe for antagonism of postoperative respiratory depression after congenital heart disease surgery in children.
