盐酸氢吗啡酮对腹腔镜胆囊切除患者血流动力学和苏醒质量的影响

目的:观察应用盐酸氢吗啡酮对腹腔镜胆囊切除(laparoscopic cholecystectomy,LC)患者血流动力学和苏醒质量的影响。方法:选择择期LC患者80例,按照随机数字表法分为研究组(盐酸氢吗啡酮组)和对照组(常规方法组),每组各40例。研究组在麻醉诱导后,手术CO2气腹建立前15 min静脉注射氢吗啡酮2 mg,对照组不予干预。比较麻醉诱导前(T0)、气腹建立时(T1)、气腹撤离时(T2)、清醒拔出气管导管时(T3)、拔管后10 min(T4)、拔管后30 min(T5)的血流动力学改变,并对患者苏醒期质量予以评价。结果:两组患者T0时的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)无统计学意义(P>0.05)。而在T1、T2、T3、T4、T5时点,研究组SBP、DBP、MAP、HR无明显波动,对照组SBP、DBP、MAP、HR均出现一定幅度的波动,两组各时点比较差异有统计学意义(P<0.05)。研究组和对照组在T3、T4、T5时点的苏醒期质量评分(RS)对比有显著性差异(P<0.05)。结论:盐酸氢吗啡酮在全麻LC中应用,可显著抑制不良应激反应,维持血流动力学平稳,改善苏醒质量,使患者得以快速康复,值得临床推广应用。

The effects of hydromorphone hydrochloride on the hemodynamics and recovery quality of patients with laparoscopic cholecystectomy

Objective:To observe the effects of hydromorphone hydrochloride on patient''s hemodynamics and recovery quality undergoing laparoscopic cholecystectomy (LC).Methods:80 patients with LC were randomly divided into study group and control group,40 cases in each group.In the study group,2 mg of hydromorphone hydrochloride was intravenously injected 15 min before CO2 pneumoperitoneum established.While in the control group,the same volume of saline was administered.The changes of hemodynamics were recorded in the following time points of just before induction (T0),just setting of pneumoperitoneum (T1),evacuating of pneumoperitoneum (T2),just extubating of the tracheal catheter (T3),10 min (T4) and 30 min after extubation (T5).The recovery quality of each patient were also observed.Results:The systolic blood pressure (SBP),diastolic blood pressure (DBP),mean arterial pressure (MAP) and heart rate (HR) were not statistically different between the two groups in T0 (P>0.05).But when compared with the study group,a certain range of fluctuation was found in the control group in the time points of T1,T2,T3,T4,T5,the difference between the two groups at each time point was statistically significant (P<0.05).The recovery quality scores in the two groups were also significant differences in the time points of T3,T4,T5,(P<0.05).Conclusion:The application of hydromorphone hydrochloridein in general anesthesia LC can significantly inhibit the stress reaction,maintain stable hemodynamics,improve the quality of recovery and enable patients to quickly recover.It is worth to apply widely in clinic.