小剂量丙泊酚复合芬太尼在全身麻醉拔管时的应用

目的观察小剂量丙泊酚复合芬太尼抑制全身麻醉拔管反应的效果。方法40例ASAⅠ~Ⅱ级的妇科患者,随机分为观察组和对照组,每组20例。2组患者应用相同的麻醉药物实施全身麻醉,手术结束,待患者清醒达到拔管条件时,观察组于拔管前3 m in静脉注射丙泊酚0.8 mg.kg-1、芬太尼0.5μg.kg-1;对照组不予用药,直接拔管。观察拔管前后平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)、呼气末二氧化碳分压(PETCO2)及躁动、呼吸抑制、呕吐、误吸、苏醒延迟的发生情况。结果观察组与对照组手术时间、术中失血量和补液量比较均无显著差异(P>0.05)。观察组MAP、HR在T1时高于T0、T2、T3、T4各时点(P<0.05),T0、T2、T3、T4各时点比较无显著性差异(P>0.05);对照组MAP、HR在T2、T3时高于T0、T1、和T4(P<0.05),T1时高于T0、T4时(P<0.05);观察组患者MAP、HR在T2、T3时明显低于对照组(P<0.05),2组其他时间点比较无显著差异(P>0.05)。观察组躁动发生率明显低于对照组(P<0.01)。2组患者各时点均无SpO2<90%、PETCO2<4.67 kPa或>6.0 kPa的情况发生;2组均无呼吸抑制、呕吐、误吸、苏醒延迟等不良反应发生。结论小剂量丙泊酚复合芬太尼可有效地抑制拔管反应。

Application of low dose propofol combined with fentanly during in endotracheal tube extubation after general anesthesia

Objective To observe the effect of low dosage propofol combined with fentanly in inhibitting the reaction during the course of tube drawing after general anesthesia. Methods Forty patients of gynecology with ASA Ⅰ - Ⅱ were randomly divided into observation group and control group（ n =20）. The same narcotics was used in general anaesthesia. After operation , when the patients were consciousness fully to draw the endotracheal tube, the patients in observation group were injected intravenously with propofol 0.8 mg · kg^-1 and fentanly 0.5 μg·kg^-1 at the time three minutes before tube drawing,then drew the endotracheal tube after sucking sputum. The patients of in control group were not injected any narcotics before tube drawing. Mean arterial pressure（MAP）, heart rate（HR）, pulse oxygen saturation （SpO2 ）, partial pressure of carbon dioxide in endexpiratory gas （ PET CO2 ） and the occurrence of restlessness, respiratory depression, vomiting, false inspiration, postanaesthetic recovery delay during tube drawing were recorded. Results There was no significant differences in the time of operation, volume of blood lost and fluid infusion during operation between observation group and control group（P 〉0.05）. In observation group,MAP and HR at T1 were higher than those at To, T2, T3 and T4 （ P 〈 0.05 ）, and there were no significant differences at To, T2, T3 and T4 （ P 〉 0. 05）. In control group, MAP and HR at T2 and T3 were higher than those at T0 ,T1 and T4（P 〈0.05） ,MAP and HR at T1 were higher than those at To and T4 （ P 〈 0.05 ） ; MAP and HR in observation group at T2, T3, were lower than those in control group （ P 〈 0.05 ） , there were no significant differences at the other time between two groups （ P 〉 0.05 ）. The restlessness rate in observation group was lower than that in control group （P 〈 0.01 ） ;There were no patients with SpO2 〈 90% PET CO2 〈 4.67 kPa or 〉 6.0 kPa in two groups. No respiratory depression, vomiting , false inspi