纳布啡和舒芬太尼喉罩全麻诱导在老年患者经尿道前列腺电切术的应用  

Application of nalbuphine and sufentanil during laryngeal mask general anesthesia induction in elderly patients undergoing transurethral resection of prostate

作　　者：袁苑[1] 贺翠莲[1] 袁凯东[1] 乔领 YUAN Yuan;HE Cuilian;YUAN Kaidong(Department of Anesthesiology,Baotou Central Hospital,Baotou014040,CHINA)

机构地区：[1]包头市中心医院麻醉科,内蒙古014040

出　　处：《江苏医药》2023年第5期466-469,474,共5页Jiangsu Medical Journal

基　　金：包头市科技计划项目(2019Z3009-8)。

摘　　要：目的比较纳布啡和舒芬太尼喉罩全身麻醉(全麻)诱导用于老年患者经尿道前列腺电切术的效果。方法行经尿道前列腺电切术的良性前列腺增生老年患者79例分为四组,喉罩全麻诱导期分别静脉推注纳布啡0.1(A组,20例)、0.2(B组,19例)、0.3mg/kg(C组,20例)和舒芬太尼0.3μg/kg(D组,20例)。记录入室时(T1)、喉罩置入前即刻(T2)、喉罩置入后1min(T3)、喉罩置入后5min(T4)、手术开始时(T5)、喉罩拔除前即刻(T6)、喉罩拔除后5min(T7)的MAP、HR、SpO2和脑电双频指数(BIS)值,统计手术时间和喉罩拔除时间,评估T7时的Ramsay镇静评分和苏醒期躁动评分,检测T1和T7时空腹血糖和皮质醇水平,观察不良反应发生情况。结果T2、T3时,D组MAP和HR低于A、B、C组,A组BIS值高于B、C、D组(P<0.05)。T3、T6时,A组MAP和HR高于B、C、D组(P<0.05)。T6时,C组BIS值低于A、B、D组(P<0.05)。T7时,C组BIS值低于A、B、D组,B、D组BIS值低于A组(P<0.05)。A组和D组T7时Ramsay镇静评分低于C组(P<0.05)。四组T7时空腹血糖和皮质醇水平均高于T1时(P<0.05)。四组恶心和嗜睡比例比较有统计学差异(P<0.05)。结论纳布啡0.2~0.3mg/kg和舒芬太尼0.3μg/kg均能有效缓解喉罩置入及拔除时的心血管系统反应,应用纳布啡0.2mg/kg更能维持喉罩全麻诱导期的循环稳定。Objective To compare the clinical efficacy of nalbuphine and sufentanil during laryngeal mask general anesthesia induction in elderly patients undergoing transurethral resection of prostate.Methods Seventy-nine elderly patients with benign prostatic hyperplasia undergoing transurethral resection of prostate were divided into four groups.During laryngeal mask general anesthesia induction,the patients were injected intravenously with nalbuphine 0.1mg/kg(group A,20 cases),nalbuphine 0.2mg/kg(group B,19cases),nalbuphine 0.3mg/kg(group C,20cases),and sufentanil 0.3μg/kg(group D,20cases),respectively.MAP,HR,SpO2and bispectral index(BIS)value of four groups were recorded at the time points of entry(T1),immediately before laryngeal mask placement(T2),one minute after laryngeal mask placement(T3),5minutes after laryngeal mask placement(T4),at the beginning of surgery(T5),immediately before laryngeal mask removal(T6),and 5minutes after laryngeal mask removal(T7).Operation time and laryngeal mask extraction time were calculated,Ramsay sedation score at T7and restlessness score during recovery period were evaluated.The levels of fasting blood glucose and cortisol at T1and T7 were detected.Adverse responses were observed.Results At T2and T3,MAP and HR of group D were lower than those of groups of A,B and C,and BIS value of group A was higher than that of groups of B,C and D(P<0.05).At T3and T6,MAP and HR in group A were higher than those in groups of B,C and D(P<0.05).At T6,BIS value of group C was lower than that of groups of A,B and D(P<0.05).At T7,BIS value of group C was lower than that of groups of A,B and D,which of groups of B and D was lower than that of group A(P<0.05).Ramsay sedation score at T7in groups of A and D was lower than that in group C(P<0.05).Fasting blood glucose and cortisol levels at T7were higher than those at T1in four groups(P<0.05).There were significant differences in nausea and lethargy among the four groups(P<0.05).Conclusion Nalbuphine 0.2-0.3mg/kg and sufentanil 0.3μg/kg can effectively atte

关 键 词：纳布啡 舒芬太尼 经尿道前列腺电切术 

分 类 号：R614[医药卫生—麻醉学]