中国医药
中國醫藥
중국의약
CHINA MEDICINE
2013年
5期
669-671
,共3页
地佐辛%气管插管%应激%患者,老年
地佐辛%氣管插管%應激%患者,老年
지좌신%기관삽관%응격%환자,노년
Dezocine%Tracheal intubation%Stress%Patients,elderly
目的 比较不同剂量地佐辛对老年患者气管插管时应激反应的影响.方法 将60例择期老年手术患者按双盲随机原则分为对照组、地佐辛1组和地佐辛2组,各20例.患者均采用全凭静脉麻醉诱导,地佐辛1组和地佐辛2组于麻醉诱导前15 min给予地佐辛0.1、0.2 mg/kg静脉注射,对照组静脉内注射芬太尼3μ g/kg,3组患者诱导均采用丙泊酚靶控输注,血浆靶控浓度为3.5 μg/kg,待患者意识消失时静脉注射顺式阿曲库铵0.2 mg/kg.监测患者入室用药前(T0)、全身麻醉诱导后插管前即刻(T1)、插管后即刻(T2)及气管插管后1(T3)、3(T4)、5 min(T5)时的HR、平均动脉压(MAP)和血浆中去甲肾上腺素、肾上腺素和血糖变化情况.结果 地佐辛1组T2～T5时间点HR、MAP分别为(88±9)、(85±8)、(84±7)、(82±8)次/min和(112±8)、(111 ±9)、(108±9)、(106±10) mm Hg(1 mm Hg =0.133 kPa),均高于T0[分别为(76±9)次/min和(97±10) mm Hg]及对照组同时间点HR、MAP[分别为(79±8)、(78±9)、(76±9)、(76±7)次/min和(103±9)、(102±8)、(100±10)、(99 ±9)mm Hg],且差异均有统计学意义(均P＜0.05)；地佐辛1组T3～T5时间点去甲肾上腺素、肾上腺素和血糖分别为(1.48±0.20)、(1.42±0.21)、(1.32±0.22) mmol/L和(1.21±0.22)、(1.15±0.20)、(1.11±0.20) mmol/L及(4.4±0.3)、(4.9±0.3)、(5.2±0.3) mmol/L,均明显高于T0[分别为(0.82±0.22)、(0.48 ±0.22)、(3.8 ±0.3)mmol/L]及对照组同时间点[分别为(0.91±0.19)、(0.92±0.18)、(0.90±0.20) mmol/L和(0.58±0.20)、(0.61±0.19)、(0.60±0.21) mmol/L及(4.0±0.4)、(4.2±0.3)、(4.2±0.4)mmol/L],差异均有统计学意义(均P＜0.05).结论 0.2 mg/kg剂量的地佐辛可有效抑制老年患者气管插管的应激反应.
目的 比較不同劑量地佐辛對老年患者氣管插管時應激反應的影響.方法 將60例擇期老年手術患者按雙盲隨機原則分為對照組、地佐辛1組和地佐辛2組,各20例.患者均採用全憑靜脈痳醉誘導,地佐辛1組和地佐辛2組于痳醉誘導前15 min給予地佐辛0.1、0.2 mg/kg靜脈註射,對照組靜脈內註射芬太尼3μ g/kg,3組患者誘導均採用丙泊酚靶控輸註,血漿靶控濃度為3.5 μg/kg,待患者意識消失時靜脈註射順式阿麯庫銨0.2 mg/kg.鑑測患者入室用藥前(T0)、全身痳醉誘導後插管前即刻(T1)、插管後即刻(T2)及氣管插管後1(T3)、3(T4)、5 min(T5)時的HR、平均動脈壓(MAP)和血漿中去甲腎上腺素、腎上腺素和血糖變化情況.結果 地佐辛1組T2～T5時間點HR、MAP分彆為(88±9)、(85±8)、(84±7)、(82±8)次/min和(112±8)、(111 ±9)、(108±9)、(106±10) mm Hg(1 mm Hg =0.133 kPa),均高于T0[分彆為(76±9)次/min和(97±10) mm Hg]及對照組同時間點HR、MAP[分彆為(79±8)、(78±9)、(76±9)、(76±7)次/min和(103±9)、(102±8)、(100±10)、(99 ±9)mm Hg],且差異均有統計學意義(均P＜0.05)；地佐辛1組T3～T5時間點去甲腎上腺素、腎上腺素和血糖分彆為(1.48±0.20)、(1.42±0.21)、(1.32±0.22) mmol/L和(1.21±0.22)、(1.15±0.20)、(1.11±0.20) mmol/L及(4.4±0.3)、(4.9±0.3)、(5.2±0.3) mmol/L,均明顯高于T0[分彆為(0.82±0.22)、(0.48 ±0.22)、(3.8 ±0.3)mmol/L]及對照組同時間點[分彆為(0.91±0.19)、(0.92±0.18)、(0.90±0.20) mmol/L和(0.58±0.20)、(0.61±0.19)、(0.60±0.21) mmol/L及(4.0±0.4)、(4.2±0.3)、(4.2±0.4)mmol/L],差異均有統計學意義(均P＜0.05).結論 0.2 mg/kg劑量的地佐辛可有效抑製老年患者氣管插管的應激反應.
목적 비교불동제량지좌신대노년환자기관삽관시응격반응적영향.방법 장60례택기노년수술환자안쌍맹수궤원칙분위대조조、지좌신1조화지좌신2조,각20례.환자균채용전빙정맥마취유도,지좌신1조화지좌신2조우마취유도전15 min급여지좌신0.1、0.2 mg/kg정맥주사,대조조정맥내주사분태니3μ g/kg,3조환자유도균채용병박분파공수주,혈장파공농도위3.5 μg/kg,대환자의식소실시정맥주사순식아곡고안0.2 mg/kg.감측환자입실용약전(T0)、전신마취유도후삽관전즉각(T1)、삽관후즉각(T2)급기관삽관후1(T3)、3(T4)、5 min(T5)시적HR、평균동맥압(MAP)화혈장중거갑신상선소、신상선소화혈당변화정황.결과 지좌신1조T2～T5시간점HR、MAP분별위(88±9)、(85±8)、(84±7)、(82±8)차/min화(112±8)、(111 ±9)、(108±9)、(106±10) mm Hg(1 mm Hg =0.133 kPa),균고우T0[분별위(76±9)차/min화(97±10) mm Hg]급대조조동시간점HR、MAP[분별위(79±8)、(78±9)、(76±9)、(76±7)차/min화(103±9)、(102±8)、(100±10)、(99 ±9)mm Hg],차차이균유통계학의의(균P＜0.05)；지좌신1조T3～T5시간점거갑신상선소、신상선소화혈당분별위(1.48±0.20)、(1.42±0.21)、(1.32±0.22) mmol/L화(1.21±0.22)、(1.15±0.20)、(1.11±0.20) mmol/L급(4.4±0.3)、(4.9±0.3)、(5.2±0.3) mmol/L,균명현고우T0[분별위(0.82±0.22)、(0.48 ±0.22)、(3.8 ±0.3)mmol/L]급대조조동시간점[분별위(0.91±0.19)、(0.92±0.18)、(0.90±0.20) mmol/L화(0.58±0.20)、(0.61±0.19)、(0.60±0.21) mmol/L급(4.0±0.4)、(4.2±0.3)、(4.2±0.4)mmol/L],차이균유통계학의의(균P＜0.05).결론 0.2 mg/kg제량적지좌신가유효억제노년환자기관삽관적응격반응.
Objective To compare the influence of different doses of dezocine on suppressing the stress response during tracheal intubation in elderly patients.Methods Sixty patients scheduled for surgery were randomly divided into control group,dezocine 1 group and dezocine 2 group (20 cases in each group).Patients in control group and dezocine 1 group,dezocine 2 group were respectively administered with fentanyl 3μg/kg and dezocine 0.1 mg/kg,dezocine 0.2 mg/kg.Three groups of patients were treated with total intravenous anesthesia.The mean arterial blood pressure (MAP),heart rate (HR) and blood noradrenergic,epinephrine,blood glucose were recorded before drug administration (T0),after induction of anesthesia immediately before intubation (T1),immediately after intubation (T2),and 1 min(T3),3 min(T4),5 min(T5) after intubation.Results The HR and MAP in dezocine 1 group at the time points of T2-T5 were (88 ± 9),(85 ± 8),(84 ± 7),(82 ± 8) times/min and (112 ±8),(111 ±9),(108 ±9),(106 ± 10)mm Hg(1 mm Hg =0.133 kPa),which were higher than those at T0 [(76 ± 9)times/min,(97 ± 10)mm Hg,respectively] and in control group at the same time points [(79 ± 8),(78 ±9),(76 ±9),(76 ±7)times per minute and (103 ±9),(102 ±8),(100 ± 10),(99 ±9)mm Hg,respectively].and the differences were statistically significant(P ＜ 0.05).The blood noradrenergic,epinephrine and blood glucose in dezocine 1 group at the time points of T3-T5 were (1.48 ± 0.20),(1.42 ± 0.21),(1.32 ±0.22)mmol/L and (1.21 ±0.22),(1.15 ±0.20),(1.11 ±0.20)mmol/L and (4.4 ±0.3),(4.9 ±0.3),(5.2±0.3)mmol/L,which was higher than the time of To[(0.82 ±0.22),(0.48 ±0.22),(3.83 ±0.34)mmol/L,respectively] and control group [(0.91 ±0.19),(0.92 ±0.18),(0.90 ±0.20) mmol/L,and (0.58 ±0.20),(0.61 ±0.19),(0.60 ±0.21) mmol/L,and (4.0 ±0.4),(4.2 ±0.3),(4.2 ±0.4) mmo]/L,respectively],and there were significant differences (all P ＜ 0.05).Conclusion The 0.2 mg/kg dose of dezocine can effectively inhibit the stress response during endotracheal intubation in elderly patients.
