不同剂量氟比洛芬酯对全麻腹腔镜单纯胆囊切除手术围拔管期中应激反应的影响  

Effects of different doses of flurbiprofen on stress response during general anesthesia of laparo- scopic choleeystectomy in trachealextubation period

作　　者：王凯[1] 谢翼[2] 刘兴敏[3] 

机构地区：[1]山东省日照市人民医院,276800 [2]淄博市中心医院 [3]贵阳医学院

出　　处：《中国实用医刊》2014年第4期8-13,共6页Chinese Journal of Practical Medicine

摘　　要：目的观察不同剂量的氟比洛芬酯抑制气管拔管应激反应的效果。方法选择50例气管插管全麻下行腹腔镜单纯胆囊切除术（LC）的手术患者，随机分为5组，每组10例，对照组脂肪乳组（I组），氟比洛芬酯0．75ms／kg组（Ⅱ组），氟比洛芬酯1mg／kg组（Ⅲ组），氟比洛芬酯1．25ms／kg组（Ⅳ组），氟比洛芬酯1．5ms／kg组（V组）。各组药物均用生理盐水稀释至12ml，胆囊切下后10min为第1次给药，第1次给药后5min为第2次给药，两次静脉分别泵注总剂量的一半，每次泵注时间〉1min。记录手术结束即刻（T1）、拔管即刻（T2）、拔管后2min（T3）、拔管后5min（T4）、拔管后10min（T5）、拔管后20min（T6）时的收缩压（SBP）、舒张压（DBP）、心率（HR），并在Tl、T2、T6时采静脉血3ml测血糖（血糖）、皮质醇（皮质醇）浓度，观察清醒时间，拔管时间，并在拔管后15、30、45min对患者的镇静（VAS）、疼痛（Ramsay）、患者满意程度（BCS）进行评估，同时记录咳嗽、恶心等不良反应的发生。结果Ⅳ组和V组减轻气管拔管应激反应及镇静、镇痛、降低不良反应、提高患者满意度的效果明显优于其他组（P〈0．05）。Ⅳ组和Ⅴ组的效果相近，两组比较差异无统计学意义（P〉0．05）。结论氟比洛芬酯1．25ms／kg有较好的镇静、镇痛作用，可降低不良反应的发生率，提高患者的满意度。Objective To observe the effects of different doses of flurbiprofen on inhibiting the stress response caused by tracheal extubation. Methods Fifty patients underwent laparoscopic cholecys- tectomy （LC） with tracheal intubation under general anesthesia were chose, and randomly divided into 5 groups （ n = 10） ： intralipid control group （ group I ）, flurbiprofen 0.75 mg/kg group （ group Ⅱ ） , flurbi- profen 1 mg/kg group （ group Ⅲ ） , flurbiprofen 1.25 mg/kg group （ groupiv ） and flurbiprofen 1.5 mg / kg group （ group Ⅴ ）. The drugs in the above groups were diluted with saline to 12 ml. The first injection will be given 10 minutes after the gallbladder was cut and the second injection will be given 5 minutes af- ter the first one. The two intravenous infusion will be half of the total dose respectively with each pumping more than 1 minute. Systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate （HR） was recorded at the end of the surgery （T1）, the time of tracheal extubation （T2）, 2 minutes after extu- bation （ T3 ）, 5 minutes after extubation （ T4）, 10 minutes after extubation （ T5 ）, and 20 minutes after extubation （T6）, and 3 ml venous blood was extracted at T1, T2 and T6 to measure the blood glucose, cortisol concentration. The time of patient＇ s consciousness and extubation was observed, and the seda- tion, pain and patient＇ s satisfaction at 15 minutes, 30 minutes and 45 minutes after extubation was eval- uated. The adverse reactions such as cough, nausea were recorded. Results In regard to ease stress re- sponse to tracheal extubation, sedation, analgesia and raising patient＇s satisfaction, the effects in group IV and group V were obviously better than those in other groups（ P 〈 0. 05 ）. The effects in group IV and V were close, there were no significant differences （ P 〉 0. 05 ）. Conclusions 1.25 mg/kg dose of flur- biprofen has good sedation and analgesia effects, can reduce the occurence of adverse e

关 键 词：全麻围拔管期 应激反应 氟比洛芬酯 血流动力学 皮质醇 血糖 

分 类 号：R614[医药卫生—麻醉学]