布托啡诺、舒芬太尼预防气管拔管应激反应的临床观察

【目的】观察布托啡诺和舒芬太尼抑制全麻患者术后气管拔管应激反应的效果。【方法】90例腹部手术患者随机分为3组（布托啡诺组、舒芬太尼组和对照组），缝皮前停用麻药时，布托啡诺组立即静脉注射布托啡诺0．02mg／kg，舒芬太尼组立即静脉注射舒芬太尼0．05μg／kg，对照组立即静脉注射生理盐水10ml。在围拔管期，观察并记录平均动脉压、呼吸、心率、指端血氧饱和度、清醒时间、拔管时问和躁动发生情况。【结果】与麻醉前相比，拔管时、拔管后2min，对照组患者平均动脉压明显升高（P〈0．05），心率、呼吸频率加快（P〈0．05）；而布托啡诺组和舒芬太尼组平均动脉压、心率、呼吸均较平稳，两组与对照组比较差异有显著性（P〈0．05）。与对照组比．布托啡诺组和舒芬太尼组躁动发生率更低（P〈0．05）；虽清醒时间延长（P〈0．05），但拔管时间三组间无显著性差异（P〉0．05）；布托啡诺组和舒芬太尼组间无显著性差异（P〉0．05）。【结论】全麻患者在拔管前静脉注射布托啡诺或舒芬太尼可抑制拔管期的应激反应。

Clinical observation of Butorphanol and Sufentanil to preventive the stress reaction of extubation

[Objective] Observes the effet of butorphanol and sufentanil to suppress the extubation response in the general anes- thesia patients. [Methods] 90 examples of abdomen surgery patients are divided into three groups stochastically （ group butor- phanol, group Sufentanil and group control） . Before shutting the stomach the seam skin stops using the maintenance anaesthetic, group butorphanol intravenous injection butorphanol 0.02 mg/kg, group sufentanil intravenous injection sufentanil 0.05μg/kg, group control intravenous injection physiological saline 10 ml. In encircles in the extubation time, To observe and record MAP, HR, RR, sPO2, extubation time and moves restlessly has the situation. [Results] Campare with the time before anesthesia, the time of extubation, 2 min after extubation, group control patients average arterial pressure obvious ascension （ P 〈 0.05 ）, HR, RR speed up （ P 〈 0.05） ; But the MAP, HR and RR of group butorphanol and group sufentanil are steady, two groups compared with group control have the significant difference （ P 〈 0.05）. With group control compared to, group butorphanol and group sufentanil moves restlessly the formation rate to be lower （ P 〈 0.05） ; Although the sober time lengthens （ P 〈 0.05）, three groups have non- significance difference on the time of extubation （P 〉 0.05）; group butorphanol and group Sufentanil have non- significance difference （P 〉 0.05）. [Conclusions] The general anesthesia patients intravenous inject butorphanol or sufentanil can suppress the stress reaction.