布托啡诺超前镇痛减轻高龄全身麻醉患者气管插管应激反应的效果  

Efficacy of preemptive analgesia with butorphanol in attenuating stress response to endotracheal intubation

作　　者：张伟 邹俊[2] 张中军[2] ZHANG Wei;ZOU Jun;ZHANG Zhongjun(Department of Anesthesiology,Wuxi Huishan District Hospital of Chinese Medicine,Wuxi 214041,CHINA)

机构地区：[1]无锡市惠山区中医医院,江苏214041 [2]无锡市第三人民医院麻醉科

出　　处：《江苏医药》2018年第11期1323-1325,共3页Jiangsu Medical Journal

摘　　要：目的观察布托啡诺超前镇痛减轻高龄全身麻醉(全麻)患者气管插管应激反应的效果。方法行全麻手术高龄患者30例,随机分为布托啡诺组(A组)和对照组(B组),每组15例。均采用静脉复合全麻。麻醉诱导均以依次静脉注射咪达唑仑2mg、芬太尼2μg/kg、丙泊酚2mg/kg和阿曲库铵0.5mg/kg。A组在气管插管诱导前15min静脉输注布托啡诺1mg,15min注完;B组注射等容量生理盐水作为对照。记录插管前1min(T1)、插管即时(T2)、插管后1min(T3)和5min(T4)时的HR和MAP,同时采用高效液相色谱法测定血浆肾上腺素(E)和去甲肾上腺素(NE)浓度。结果A组围气管插管期的HR和MAP低于B组(P<0.05),血浆E和NE浓度也低于B组(P<0.05)。结论全麻诱导前使用布托啡诺超前镇痛能有效减轻高龄全麻患者气管插管的应激反应。Objective To observe the efficacy of preemptive analgesia with butorphanol in attenuating the stress response to endotracheal intubation.Methods Thirty elderly patients were randomly assigned into two groups with 15 cases each.Intravenous combined general anesthesia was performed in both groups.Anesthesia induction was conducted by intravenous injection of midazolam2 mg,fentanyl 2μg/kg,propofol 2 mg/kg and atracurium 0.5 mg/kg.Butorphanol 1 mg in group A was intravenously infused in 15 minutes before endotracheal intubation.The patients in group B were infused equal volume of normal saline as the controls.The HR and MAP were recorded at 1 minute before intubation(T1),during intubation(T2),at 1 minute(T3)and 5 minutes(T4)after intubation.Plasma levels of adrenaline and norepinephrine were detected by high efficiency liquid chromatography at the same time points.Results The HR,MAP and plasma levels of adrenaline and norepinephrine were all lower perioperatively in group A than those in group B(P<0.05).Conclusion Preemptive analgesia with butorphanol before anesthesia induction is effecive in attenuating the stress response to endotracheal intubation in aged patients.

关 键 词：布托啡诺 超前镇痛 气管插管 应激反应 老年 

分 类 号：R614[医药卫生—麻醉学]