CAJ | 학술논문

目的：观察盐酸纳美芬对行腹腔镜胆囊切除术的影响。方法择期腹腔镜下胆囊切除术老年患者30例，随机均分为生理盐水对照组（ A组）和盐酸纳美芬组（ B组）。 B组术毕时接受静脉注射0．25μg? kg－1盐酸纳美芬，A组则给予相同容量的生理盐水。记录两组患者个时间段的心率（HR）和平均动脉压（MAP），观察苏醒时间、脑电双频指数（BIS）值，转入麻醉恢复室（PACU）后躁动发生情况和疼痛VAS分级。结果与A组比较，盐酸纳美芬组在T2～T5时段MAP和HR明显降低（P＜0．05）；自主呼吸恢复时间、睁眼时间和拔管时间均明显降低（P＜0．05）；T3～T4时间段BIS值明显增高（P＜0．05）；拔管后转入PACU期间躁动分级和躁动发生率也明显降低（P＜0．05），VAS临床评定优良率两组间无统计学差异。结论盐酸纳美芬在老年腹腔镜胆囊切除术中可以缩短患者术后苏醒时间，减少围麻醉期不良事件的发生率。
목적：관찰염산납미분대행복강경담낭절제술적영향。방법택기복강경하담낭절제술노년환자30례，수궤균분위생리염수대조조（ A조）화염산납미분조（ B조）。 B조술필시접수정맥주사0．25μg? kg－1염산납미분，A조칙급여상동용량적생리염수。기록량조환자개시간단적심솔（HR）화평균동맥압（MAP），관찰소성시간、뇌전쌍빈지수（BIS）치，전입마취회복실（PACU）후조동발생정황화동통VAS분급。결과여A조비교，염산납미분조재T2～T5시단MAP화HR명현강저（P＜0．05）；자주호흡회복시간、정안시간화발관시간균명현강저（P＜0．05）；T3～T4시간단BIS치명현증고（P＜0．05）；발관후전입PACU기간조동분급화조동발생솔야명현강저（P＜0．05），VAS림상평정우량솔량조간무통계학차이。결론염산납미분재노년복강경담낭절제술중가이축단환자술후소성시간，감소위마취기불량사건적발생솔。
OBJECTIVE To investigate the effects of nalmefene on aged patients receiving laparoscopic chole-cystectomy.METHODS 30casesofagedpatientswererandomlydividedinto2groups:controlgroup(Agroup) and nalmefene group ( B group).Patients in group B received 0.25μg? kg -1 nalmefene and patients in group A re-ceived saline of equivalent capacity at the induction of anesthesia.HR and MAP were observed on defferent time.BIS,awakening time and operation time were all recorded.Moreover,the occurrence of agitation and the postop-erative VAS scale were observed in PACU.RESULTS Nalmefene significantly reduced HR and MAP during T2 ~T5 period and increased BIS during T3 ~T4 period compared with control group.Moreover,nalmefene obviously de-creased the occurrence of agitation.There were no significant differences of VAS scale between control and nalmefene group.CONCLUSION Nalmefene infusion in geriatric laparoscopic cholecystectomy can reduce the recovery time of anesthesia and the adverse reaction.