参附注射液对全身麻醉患者恢复期的催醒作用研究

The Research in Resuscitation Efficacy of Shenfu Injection from General Anesthesia Patients in Recovering Period

目的:研究参附注射液(SF)对全身麻醉患者恢复期的催醒作用并探讨其机制。方法:52例择期气管插管全身麻醉下行腹部手术的患者,按美国麻醉师协会(ASA)评分Ⅰ或Ⅱ级,术毕送入麻醉恢复室(PACU),随机分为两组:SF组和对照组各26例。SF组15min内静脉滴注催醒液(SF0.5mL·kg-1),对照组给予等量生理盐水。记录2组患者呼唤反应恢复时间、自主呼吸恢复时间、拔管时间及在PACU停留时间;并记录两组给药前及给药后15、25、50min的平均动脉压(MAP)、心率(HR)及动脉血肾上腺素(E)、去甲肾上腺素(NE)、β-内啡肽(β-EP)的浓度。结果:血流动力学参数MAP与HR对照组给药前、后差异无统计学意义,SF组给药后25min及50min与给药前比较及与对照组同时点比较差异有统计学意义;E、NE、β-EP浓度对照组给药前、后差异无统计学意义,SF组给药后各时点均升高并显著高于对照组(P<0.05)。结论:SF能明显加快全身麻醉患者苏醒,可能与其有效增强应激反应,使β-内啡肽水平升高有关。

Objective To investigate the effect and the mechanism of Shenfu injection（SF） on the resus-citation from general anesthesia.Methods Fifty patients who received selective abdominal surgery with general anesthesia for 3-4 hrs and ASA gradeⅠ-Ⅱ were divided into two groups,the SF group and the control group,26 patients in each group.After being sent into the postanesthesia care unit（PACU）,the SF group was treated with intravenous dripping of SF 0.5 mL·kg-1 in 15 minutes and the control group was treated with intravenous dripping of equal volume of normal saline.The following times were recorded：（1） the time when the patients opened their eyes on command;（2） the time when mechanical ventilation was stopped;（3） the time when oxygen inhalation was stopped;（4） the extubation time;（5） the time of staying in PACU.The mean arterial pressure（MAP）,heart rate（HR）,the concentrations of Epinephrine（E）,Norepinephrine（NE） and β-endorphin（β-EP） in arterial blood were detected at 15,25,50 minutes before and after medication.Results No statistically significant differences were noted for control group in MAP and HR of hemodynamics parameters after medication as compared with those before medication,but statistically significant differences were noted for SF group at 25 min and 50 min when compared with those before medication or compared with those in the control group at the same time points.The differences of E,NE and β-EP in plasma levels were non statistically significant in control group after medication as compared with those before medication,whereas the plasma levels of E,NE and β-EP at each time points increased in SF group and which were statistically significantly higher than those in the control group（P 0.05）.Conclusion The remarkable analeptic action of SF for patients undergoing total intravenous anesthesia might be attributed to its action in effectively strengthening the stress reaction to let β-EP level higher.