盐酸羟考酮预防老年食道癌根治术患者全麻苏醒期谵妄的临床研究  

Clinical study of oxycodone hydrochloride on the prevention of emergency delirium in older patients undergoing esophagectomy

作　　者：刘洋[1] 潘甜[1] 余亮[1] 黄惠莲[1] 汪卫星[1] 

机构地区：[1]湖州市中心医院麻醉科,浙江湖州313000

出　　处：《中华全科医学》2016年第4期527-529,558,共4页Chinese Journal of General Practice

基　　金：浙江省自然科学基金(LQ13H160019)

摘　　要：目的观察盐酸羟考酮对老年食道癌根治术患者全麻苏醒期谵妄的预防效果。方法选取湖州市中心医院自2014年6月—2015年6月择期静吸复合全身麻醉下行右侧卧位胸腔镜下食道癌根治术患者60例,ASAⅠⅢ级,年龄≥60岁。采用随机数字表法,将患者分为羟考酮组（O组,30例）和舒芬太尼组（S组,30例）,所有患者采用左侧双腔支气管导管行右侧肺单肺通气。手术结束前15 min,给2组患者分别静注盐酸羟考酮0.07mg/kg和等容舒芬太尼0.15μg/kg。记录手术时间、单肺通气时间、术中出血量、尿量、液体输注量及种类;记录睁眼时间、呼吸恢复时间、拔管时间;术前1 d和术后苏醒期采用ICU谵妄评估法进行谵妄状态评定;记录进入麻醉后监测治疗室（PACU）即刻、5、15、30、50、60 min时视觉模拟评分（VAS）、Riker镇静躁动评分（SAS）及不良反应（恶心、呕吐、嗜睡、呼吸抑制）发生情况。结果与S组比较,O组患者睁眼时间、呼吸恢复时间、拔管时间显著缩短（P〈0.05）;术后谵妄发生率、嗜睡发生人数显著降低（P〈0.05）;各监测时间点VAS及Riker镇静躁动评分显著降低（P〈0.05）。结论手术结束前15 min静注盐酸羟考酮可以预防老年食道癌根治术患者全麻苏醒期谵妄的发生。Objective To evaluate the effect oxycodone hydrochloride on the prevention of emergency delirium in older patients undergoing esophagectomy after general anesthesia. Methods Sixty ASAⅠ- Ⅲ patients,age≥60 years old,received general anesthesia and OLV using left double-lumen endotracheal tube undergoing esophagectomy,were randomly divided into group O（ n = 30） and group S（ n = 30）,patients were assigned to give intravenous oxycodone 0. 07 mg / kg,while sufentanil 0. 15 μg / kg（ equal volume of normal saline）15 min before the end of the operation. Records were made on the recovery time of autonomous respiration,called eye opening time,extubation time during recovery period. The incidence and severity of the VAS and the SAS were observed and recorded in the PACU,at arrival,5,15,30,50 and 60 min.Adverse reactions of patients and emergency delirium were observed. Results Compared with group S of patients the incidence of emergency delirium and drowsiness significantly lower（ P〈0. 05）;VAS score,Riker SAS score,decreased significantly in group O（ P〈0. 05）. Conclusion Oxycodone can reduce the emergency delirium during recovery period in older patients undergoing esophagectomy after general anesthesia.

关 键 词：谵妄 盐酸羟考酮 全身麻醉 苏醒期 手术后 

分 类 号：R614.2[医药卫生—麻醉学]