纳布啡复合地塞米松预防鼻咽部手术患者苏醒期躁动的效果  

The Efficacy of Nalbuphine Combined with Dexamethasone in the Prevention of Emergence Agitation in Patients Undergoing Nasopharynx Surgery

作　　者：何旭秀 He Xuxiu(Qinghai Traditional Chinese Medicine Hospital,810000)

机构地区：[1]青海省中医院麻醉科,810000

出　　处：《青海医药杂志》2020年第12期1-5,共5页Qinghai Medical Journal

摘　　要：目的:分析纳布啡复合地塞米松预防鼻咽部手术患者苏醒期躁动的有效性和安全性。方法:收集2018年1月—2019年1月于我院行全身麻醉下鼻咽部手术的患者60例,随机分为三组,每组各20例:纳布啡组(N组)、纳布啡+地塞米松组(ND组)和对照组(C组),三组采用相同的静脉麻醉。手术结束前30min,三组患者分别静脉注射纳布啡0.2mg/kg、纳布啡0.2mg/kg+地塞米松0.2mg/kg和等容量生理盐水。术毕所有药物停止注入。记录手术时间、停药至清醒时间、拔管时间;记录躁动发生情况、持续时间及患者苏醒后即刻(T_(0))、苏醒后15min(T_(1))、30min(T_(2))时的SAS评分和Ramsay评分。结果:与C组比较,N组和ND组T0~T2时Ramsay评分明显增加,SAS评分明显降低(P<0.05);尤其ND组T0~T2时Ramsay评分明显增加及SAS评分明显降低,躁动例数明显减少(P<0.05)。结论:纳布啡组和纳布啡+地塞米松组均能有效减少鼻咽部手术患者苏醒期躁动的发生,且纳布啡+地塞米松组的患者躁动程度明显减轻,不良反应少。Objective:This paper is aimed to evaluate the efficacy and safety of nalbuphine combined with dexamethasone in the prevention of emergence agitation in patients undergoing nasopharynx surgery.Methods:Sixty patients whowere treated with elective general anesthesia in the nasopharynx surgery were chosen.These patients in ASA(Ⅰ~Ⅱ),aging from 25 to 68 year old,and weighing from 46 to 70 kg,were randomly divided into three groups:nalbuphine group(N group),nalbuphine and dexamethasone group(ND group)and control group(C group).All three groups received the same intravenous anesthesia.Thirty minutes before the end of the operation,Group N was injected intravenously with nalbuphine 0.2 mg/kg,Group ND was injected intravenously with nalbuphine 0.2 mg/kg and dexamethasone 0.2 mg/kg,and Group C was injected intravenously with equal volume saline.All drugs were stopped after operation.The time of operation and the time from drug withdrawal to awake and extubation were recorded.The occurrence and duration of agitation were recorded.SAS score and Ramsay score were performed immediately(T_(0)),5 minutes(T_(1))and 30 minutes(T_(2))after the patient’swaking up.Results:Compared with group C,Ramsay score increased and SAS score decreased significantly in group N and group ND(P<0.05)at the point of T0~T2,and in particular,the ND group of patients with more significant changes.Conclusion:Both nalbuphine group and nalbuphine combined with dexamethasone group can effectively reduce the incidence of agitation in the wake period of patients undergoing nasopharynx surgery.However,the patients in nalbuphine combined with dexamethasone had less agitation and less adversereactions.

关 键 词：纳布啡 地塞米松 鼻咽部手术 苏醒期躁动 

分 类 号：R614.2[医药卫生—麻醉学] R971.2[医药卫生—外科学]