盐酸丁丙诺啡抑制气管拔管期应激反应的作用

目的观察盐酸丁丙诺啡对全身麻醉苏醒拔管期机体应激反应的影响。方法60例ASAⅠ～Ⅱ级择期全麻下剖腹手术患者,随机分为三组,每组20例,对照组(C组)注射生理盐水;盐酸丁丙诺啡3μg/kg组(B3组)缝皮前静脉注射3μg/kg盐酸丁丙诺啡;盐酸丁丙诺啡6μg/kg组(B6组)缝皮前静脉注射盐酸丁丙诺啡6μg/kg。所有患者均给予异丙酚、维库溴胺、芬太尼作为全麻诱导用药,气管插管后及手术中微泵持续静脉注射异丙酚,间断静脉注射维库溴胺维持全麻及肌松。分别于术前、拔管时和拔管后5min测量血压、心率和呼吸及血氧饱和度;并对血压、呼吸、患者清醒程度、肢体运动进行评估。记录拔管时躁动的发生率及清醒时的拔管时间。结果C组血液动力学受影响较大,拔管时SBP和HR与术前比较有非常显著升高(P<0.01);盐酸丁丙诺啡B3组和B6组血液动力学较平稳,SBP、HR和SPO2与术前比较无显著性差异(P>0.05)。拔管后5min各组各项指标基本恢复到术前水平。结论盐酸丁丙诺啡能减轻全身麻醉苏醒拔管期机体应激反应,盐酸丁丙诺啡3μg/kg静脉注射即能很好的抑制应激反应。

The inhibition of buprenorphine on stress response indced by tracheal extubation

Objective To observe the impact of intravenous buprenorphine on stress response induced by tracheal extubation. Methods The 60 cases of ASA Ⅰ-Ⅱ patients, which were scheduled for selective surgery of abdomen were randomly divided into three groups and received a standard general anesthesia consisting of fentanyl,propofol,vercuronium and isoflurane. After the operation, buprenorphine 3μg/kg (Group B3), buprenorphine 3μg/kg (Group B6),the normal saline (Group C) were given respectively by intravenousy injection,postoperative tracheal extubation was performed when acceptable criteria was achieved. Non-invasive arterial pressure(SBP),heart rate (HR) and SPO2 were recorded before operation,as well when tracheal extubation and 5min after extubation. Results Group C was more increased when extubation than before operation in SBP,HR(P<0.01); In Group B3 and Group B6,SBP,HR and SPO2 were no significant variation(P>0.05). Of GroupC,B3 and B6, in all parameters there were no significant variations between before operation and 5min after extubation(P>0.05). Conclusion Intravenous injection of buprenorphine 3μg/kg can effectively relieve stress response inducde by tracheal extubation.