不同剂量布托啡诺对全麻诱导期的血流动力学及Narcotrend指数的影响  

Effect of Different Doses of Butorphanol on Hemodynamics and Narco⁃trend Index During Induction of General Anesthesia

作　　者：肖丽珠 刘召国 胡契宇 张娇玲 鲁靖 XIAO Lizhu;LIU Zhaoguo;HU Qiyu;ZHANG Jiaoling;LU Jing(Department of Anesthesiology,the First Affiliated Hospital of Hunan Medical College,Huaihua,Hunan Province,418000 China)

机构地区：[1]湖南医药学院第一附属医院麻醉科,湖南怀化418000

出　　处：《系统医学》2024年第3期24-27,共4页Systems Medicine

基　　金：湖南省医学会医学科研基金(HMA202101012)。

摘　　要：目的比较不同剂量布托啡诺预处理对全麻诱导期的血流动力学及Narcotrend指数(Narcotrend Index,NI)的影响。方法选取2021年10月—2022年10月湖南医药学院第一附属医院进行腹腔镜手术的患者160为研究对象,采用随机双盲法将患者分为4组,每组40例,全麻诱导前5 min分别给与生理盐水(D组)、布托啡诺10μg/kg(B_(1)组)、布托啡诺20μg/kg(B_(2)组)、布托啡诺30μg/kg(B_(3)组)的预处理。记录药物预处理前(T_(0))、诱导前(T_(1))、气管插管前即刻(T_(2))、气管插管后1、3、5 min(T_(3)~T5)4组的血流动力学指标、NI以及诱导期不良反应发生情况。结果4组间血流动力学指标比较,差异无统计学意义(P>0.05)。T_(3)时D组、B_(2)组NI值明显高于B_(3)组,T_(1)时D组NI值明显高于B_(1)组,T5时B_(2)组NI值明显高于D组、B_(3)组,差异有统计学意义(P均<0.05)。B_(1)组总不良反应发生率为8%,明显低于D、B_(2)、B_(3)组,差异有统计学意义(P均<0.05)。结论布托啡诺预处理能降低麻醉诱导期NI值,10μg/kg布托啡诺剂量最佳,既能抑制全麻诱导期强烈的插管应激反应,又能维持血流动力学的稳定,且不良反应最少。Objective To compare the effects of different doses of butorphanol pretreatment on hemodynamics and Narcotrend index(NI)during general anesthesia induction.Methods A total of 160 patients undergoing laparoscopic surgery in the First Affiliated Hospital of Hunan Medical University from October 2021 to October 2022 were selected as the study objects and divided into 4 groups with 40 patients in each group by random double-blind method.Normal saline(group D),butorphanol 10μg/kg(group B_(1)),butorphanol 20μg/kg(group B_(2))and butorphanol 30μg/kg(group B_(3))were pretreated 5 min before general anesthesia induction,respectively.Hemodynamic indexes,NI,and adverse re⁃action occurrence during induction were recorded in 4 groups before pretreatment(T_(0)),before induction(T_(1)),immedi⁃ately before tracheal intubation(T_(2)),1,3 and 5 min after tracheal intubation(T_(3)-T5).Results There was no significant difference in hemodynamic indexes among the 4 groups(P>0.05).NI value in groups D and B_(2)was significantly higher than that in group B_(3)at T_(3),NI value in group D was significantly higher than that in group B_(1)at T_(1),and NI value in group B_(2)was significantly higher than that in group D and B_(3)at T5,and the differences were statistically significant(all P<0.05).The total incidence of adverse reactions in group B_(1)was 8%,which was significantly lower than that in groups D,B_(2)and B_(3),and the differences were statistically significant(all P<0.05).Conclusion Butorphanol pretreat⁃ment can reduce NI value during anesthesia induction,and 10μg/kg butorphanol dose is the best,which can not only inhibit the strong intubation stress response during general anesthesia induction,but also maintain hemodynamic sta⁃bility with the least adverse reactions.

关 键 词：布托啡诺 血流动力学 NARCOTREND指数 全麻诱导 

分 类 号：R614[医药卫生—麻醉学]