纳布啡辅助抑制腹腔镜胆囊切除术麻醉诱导时舒芬太尼诱发呛咳反应的效果  

The Effect of Nalbuphine in Assisting the Suppression of Sufentanil-Induced Cough Reflex during Anesthesia Induction for Laparoscopic Cholecystectomy

作　　者：宋佩 SONG Pei(Department of Anesthesiology and Perioperative Medicine,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450002)

机构地区：[1]郑州大学第二附属医院麻醉与围术期医学部,河南郑州450002

出　　处：《医学临床研究》2025年第2期214-217,共4页Journal of Clinical Research

摘　　要：【目的】探讨纳布啡辅助抑制腹腔镜胆囊切除术(LC)麻醉诱导时舒芬太尼诱发呛咳反应的效果。【方法】82例行LC的患者,随机分为观察组与对照组,每组41例。两组患者均采用舒芬太尼麻醉诱导,麻醉诱导前10 min,对照组静脉注射0.01 mg/kg盐酸戊乙奎醚,观察组静脉注射0.01 mg/kg盐酸戊乙奎醚+0.1 mg/kg纳布啡。比较两组麻醉中呛咳反应发生情况,血流动力学和应激指标变化,疼痛情况及不良反应。【结果】观察组呛咳反应发生率低于对照组(P<0.05),两组呛咳反应持续时间比较,差异无统计学意义(P>0.05)。两组患者注射舒芬太尼后2 min(T_(2))时平均动脉压(MAP)、心率(HR)低于注射舒芬太尼前10 min(T_(0))、注射后1 min(T_(1))时(P<0.05),且T_(1)时低于T_(0)时(P<0.05);观察组T_(1)、T_(2)时MAP、HR均高于对照组(P<0.05)。两组患者术后4 h(T_(4))、术后24 h(T_(5))时疼痛数字等级评分(NRS)低于苏醒时(T_(3))时(P<0.05),T_(5)时NRS评分低于T_(4)时(P<0.05);但两组患者各时刻NRS评分比较,差异无统计学意义(P>0.05)。术后24 h,两组肾上腺素、去甲肾上腺素水平较术前均升高(P<0.05),但两组比较,差异均无统计学意义(P>0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】纳布啡辅助抑制LC麻醉诱导时舒芬太尼诱发的呛咳反应效果确切,对患者血流动力学影响较小,可减轻患者术后疼痛,且安全可靠。【Objective】To investigate the effect of nalbuphine in suppressing the cough reflex induced by sufentanil during anesthesia induction for laparoscopic cholecystectomy(LC).【Methods】A total of 82 patients undergoing LC were randomly divided into the observation group and the control group,with 41 patients in each group.Both groups were administered sufentanil for anesthesia induction.Ten minutes before induction,the control group received 0.01 mg/kg of penehyclidine hydrochloride intravenously,while the observation group received 0.01 mg/kg of penehyclidine hydrochloride plus 0.1 mg/kg of nalbuphine intravenously.The incidence of cough reflex,hemodynamic and stress marker changes,pain levels,and adverse reactions were compared between the two groups.【Results】The incidence of cough reflex was lower in the observation group than in the control group(P<0.05).There was no significant difference in the duration of cough reflex between the two groups(P>0.05).At 2 minutes after sufentanil injection(T_(2)),the mean arterial pressure(MAP)and heart rate(HR)were lower in both groups compared to 10 minutes before injection(T_(0))and 1 minute after injection(T_(1))(P<0.05),and they were lower at T_(1)than at T_(0)(P<0.05).MAP and HR at T_(1)and T_(2)were higher in the observation group compared to the control group(P<0.05).The numerical rating scale(NRS)pain scores at 4 hours(T_(4))and 24 hours(T_(5))postoperatively were lower than at T_(3)in both groups(P<0.05),and the scores at T_(5)were lower than at T_(4)(P<0.05);however,there was no significant difference in NRS scores between the two groups at any time point(P>0.05).At 24 hours postoperatively,adrenaline and norepinephrine levels were elevated compared to preoperative levels in both groups(P<0.05),but there was no significant difference between the groups(P>0.05).The overall incidence of adverse reactions was not significantly different between the two groups(P>0.05).【Conclusion】Nalbuphine effectively suppresses sufentanil-induced cough reflex during anesth

关 键 词：胆囊切除术 腹腔镜 纳布啡 舒芬太尼 麻醉 

分 类 号：R657.4[医药卫生—外科学]