布托啡诺与芬太尼用于短时手术全身麻醉的临床比较研究

《布托啡诺与芬太尼用于短时手术全身麻醉的临床比较研究》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、布托啡诺与芬太尼用于短时手术全身麻醉的临床比较研究【摘要】比较布托啡诺与芬太尼用于短时手术全麻中的临床效果及不良反应，评价布托啡诺用于全麻的临床作用及安全性。方法ASAⅠ～Ⅱ级耳鼻咽喉科择期声带息肉摘除术住院患者40例，手术时间（12±2）min，随机分为布托啡诺组（B组，n=20）和芬太尼组(F组,n=20)。B组诱导静脉注射布托啡诺20μg·kg-1，F组诱导静脉注射芬太尼5μg·kg-1，2组4min后均静脉注射丙泊酚及琥珀胆碱行气管插管控制呼吸，术中静脉输注丙泊酚、瑞芬太尼及琥珀胆碱维持麻醉。术中监测平均动脉压（MAP）、心率（HR）、脉搏血氧

2、饱和度（SpO2）、呼吸频率（RR）、术后Ramsay镇静评分及VAS镇痛评分、不良反应和拔管时间。结果①与术前相比，B组静脉注射布托啡诺后及术后RR、SpO2无明显变化(P>0.05)；F组静脉注射芬太尼后及术后RR下降显著(P<0.05)，术后拔管时间明显大于B组(P<0.05)。②B组各时间点MAP、HR变化不明显(P>0.05)；F组静脉注射芬太尼后HR下降显著(P<0.05)。③拔管后B组VAS评分明显低于F组(P<0.05)。④F组呛咳、恶心、肌肉僵直、寒颤、呼吸抑制等不良反应发生率明显高于B组(P<

3、;0.05)。结论静脉注射20μg·kg-1布托啡诺可安全用于短时手术全身麻醉，不良反应发生率低。【关键词】布托啡诺全身麻醉短时手术芬太尼Abstact:ObjectiveToevaluatetheclinicaleffectand7safetyofbutorphanolinducedgeneralanesthesiainshort-timeoperationagainstthefentanylinducedone.MethodsFortypatients,withASAgradesⅠandⅡ,diagnosedtohavepolypofvocalco

4、rdforextirpation,wererandomlydividedinto2groupsof20each:butorphanolgroup(groupB)andfentanylgroup(groupF).Anesthesiawasinducedwithbutorphanol(20μg·kg-1)ingroupBandwithfentanyl(5μg·kg-1)ingroupF.Fourminlater,intravenouspropofol(2mg·kg-1)andanectine(1.5mg·kg-1)weregiventointubateth

5、etracheaandstartmechanicalventilation.Theanesthesiawasthenmaintainedwithintravenouspropofol,remifentanilandanectineduringtheoperation.Theheartrate(HR),meanarterialbloodpressure(MAP),respiratoryrate(RR),saturationofpulseoxygen(SpO2)andadverseeffectswerenoticedbeforeandduringtheop

6、erationandaftertheextubation.Thequalityofanalgesiaandsedationwasscoredafterextubation,withthetimeofextubationputdown.ResultsTherewerenosignificantchangesinRRandSpO2ingroupBaftertheintravenousbutorphanolandtheoperation(P>0.05).ButtheRRdroppedsignificantlyingroupFafterintraveno

7、usfentanylandtheoperation(P<0.05),sothetimeofextubationhadtobepostponed.TheMAPandHRwerenotalteredingroupB,buttheHRdroppedmarkedlyingroupF(P<0.05).7TheVASvalueafterextubationwassignificantlyloweringroupBthaningroupF(P<0.05).Theadversegagging,bucking,shiveringandrespirato

8、rydepressionweresignificantlylessmarkedingroupB