纳布啡和舒芬太尼气管插管全麻在腹腔镜下全子宫切除手术中效果比较  

Comparison of the effect of nalbuphine and sufentanil for tracheal intubation general anesthesia during laparoscopic total hysterectomy

作　　者：商璐璐 葛建岭[1] 王伟[1] SHANG Lulu;GE Jianling;WANG Wei(The First People's Hospital of Chuzhou,Anhui Province,239000)

机构地区：[1]安徽省滁州市第一人民医院,239000

出　　处：《中国计划生育学杂志》2025年第2期295-299,共5页Chinese Journal of Family Planning

摘　　要：目的:探究盐酸纳布啡(NH)和舒芬太尼(SF)气管插管全麻在腹腔镜下全子宫切除手术(LTH)中的应用效果。方法:选取2020年10月-2024年3月本院行LTH的患者88例,简单随机分为SF组(n=44)和NH组(n=44),两组均基于复合用药基础(0.2mg/kg顺库+0.1mg/kg丙泊酚+0.2mg/kg依托咪酯+0.04mg/kg咪达唑仑)分别采用0.2mg/kg NH、0.3μg/kg SF诱导气管插管全麻。比较两组不同时间点血流动力学指标,术后不同时间点动、静息疼痛视觉模拟评分(VAS)评分,术后麻醉恢复指标、镇痛情况及不良反应。结果:SF组、NH组血流动力学指标心率和平均动脉压在入室(T0)-拔管后(T5)均呈先下降后上升趋势;NH组麻醉诱导15min后(T1)-T5时心率和平均动脉压均高于SF组,术后4h、8h、12h运动与静息VAS评分均低于SF组,术后镇痛泵按压数(2.10±0.67次)少于SF组(3.08±0.71次),拔管呛咳、恶心呕吐总计发生率(0)低于SF组(9.1%)(均P<0.05)。结论:相较于SF诱导气管插管复合全麻,NH诱导气管插管复合全麻效果更佳,可更好维持行LTH的女性机体体征稳定,促进术后麻醉恢复,下调疼痛感和不良反应发生风险。Objective:To explore the application effect of nalbuphine hydrochloride(NH)and sufentanil(SF)for tracheal intubation general anesthesia during laparoscopic total hysterectomy(LTH).Methods:88 patients who wanted LTH in the hospital were selected and were divided into two groups(44 cases in each group)by simple randomization method from October 2020 to March 2024.The patients in both groups were given the compound medication(0.2 mg/kg cisatracurium besylate+0.1 mg/kg propofol+0.2 mg/kg etomidate+0.04 mg/kg midazolam)for anesthesia,and the patients in group A were given induced anesthesia by 0.2 mg/kg NH and the patients in group B were given induced anesthesia 0.3μg/kg SF before the tracheal intubation general anesthesia.The hemodynamic indexes at different time points,the exercise and resting scores of the visual analogue scale(VAS)at different time points after surgery,the postoperative anesthesia recovery indexes values,the analgesia status and the incidence of the adverse reactions of the patients were compared between the two groups.Results:The values of the heart rate and the mean arterial pressure of the patients in the two groups had decreased firstly and then increased from the time of entering the operative room(T0)to the time of extubation(T5).The values of the heart rate and the mean arterial pressure of the patients in group A at 15min after induction of anesthesia(T1)-T5 were significantly higher than those of the patients in group B.The exercise and rest scores of VAS of the patients in group A at 4h,8h and 12h after operation were significantly lower than those of the patients in group B.The number of the postoperative analgesic pump pressing(2.10±0.67 times)of the patients in group A was significantly less than that(3.08±0.71 times)of the patients in group B.The total incidence of bucking,nausea and vomiting(0)of the patients in group B at extubation was significantly lower than that(9.1%)of the patients in group B(all P<0.05).Conclusion:Compared with that of the induced tracheal intubation comb

关 键 词：腹腔镜下全子宫切除手术 气管插管 全麻 纳布啡 舒芬太尼 镇痛 血流动力学 

分 类 号：R61[医药卫生—外科学]