哌甲酯用于成人阻塞性呼吸睡眠低通气暂停综合征全麻术后催醒观察  

Clinical Study of Ritalin in Resuscitation after General Anesthesia for Adult Obstructive Respiratory Sleep Hypopnea Syndrome

作　　者：任俏[1] 王洁 王向宇 Ren Qiao;Wang Jie;Wang Xiangyu(Department of Anesthesiology, Luohu District Peoplezs Hospital, Guangdong Shenzhen 518001,China)

机构地区：[1]深圳市罗湖区人民医院麻醉科

出　　处：《中国药师》2019年第10期1871-1873,共3页China Pharmacist

基　　金：罗湖区软科学研究计划项目(编号:2018021)

摘　　要：目的:观察哌甲酯对成人阻塞性呼吸睡眠低通气暂停综合征(OSAHS)全麻术后苏醒的作用。方法:60例OSAHS患者根据住院号末尾数字分组,每组各30例。奇数者进入观察组,予哌甲酯催醒;偶数者进入对照组,予氟马西尼催醒,比较两组患者给药前(T0)及给药后1 min(T1)、5 min(T2)、10 min(T3)、30 min(T4)的平均动脉压(MAP)、心率(HR)、镇静/警觉评分(OOA/S)以及手术时间、丙泊酚用量、苏醒时间、拔管时间和术后24 h不良反应发生率。结果:两组患者各时间点的MAP、HR差异无统计学意义(P>0.05);两组患者T3时间点的MAP、HR均较T0时间点明显升高(P<0.05)。两组患者OOA/S评分随时间延长而升高,且观察组T1、T2和T3时间点的OOA/S评分均显著高于对照组(P<0.05)。两组患者的手术时间和丙泊酚用量差异无统计学意义(P>0.05),观察组的苏醒时间、拔管时间、术后24 h不良反应发生率均小于对照组(P<0.05)。结论:哌甲酯对成人OSAHS全麻术后有催醒作用,可以缩短苏醒和拔管时间,对血流动力学无影响,不良反应发生率低,且优于氟马西尼。Objective: To explore the effect of ritalin on recovery of adult obstructive sleep hypopnea syndrome( OSAHS) after general anesthesia. Methods: Totally 60 patients with OSAHS were selected. According to the number at the end of hospitalization number,the odd number was the experimental group awakened by ritalin,and the even number was the control group awakened by flumazenil,and 30 cases were in each group. The mean arterial pressure( MAP),heart rate( HR) and sedation/alertness score( OOA/S) before the administration( T0) and at 1 min( T1),5 min( T2),10 min( T3) and 30 min( T4) after the administration,and the operation time,propofol dosage,awakening time,extubation time and incidence of adverse reactions in 24 hours after the operation were compared between the groups. Results: There were no significant differences in MAP and HR between the groups at each time point( P > 0. 05),while the MAP and HR at T3 in the groups were higher than those at T0 in the same group( P < 0. 05). The OOA/S scores in the two groups increased with time,and the OOA/S scores in the experimental group at T1,T2 and T3 were significantly higher than those in the control group with statistically significant differences( P < 0. 05). There were no significant differences in the operation time and propofol dosage between the groups( P > 0. 05). The recovery time,extubation time and incidence of adverse reactions in the experimental group were less than those in the control group( P < 0. 05). Conclusion: Ritalin has a wake-up effect in adult OSAHS patients after general anesthesia. It can shorten the time of awakening and extubation without influence on hemodynamics,and has low incidence of adverse reactions,which is superior to flumazenil.

关 键 词：哌甲酯 阻塞性呼吸睡眠低通气暂停综合征 氟马西尼 全麻 

分 类 号：R971[医药卫生—药品]