凯纷静脉镇痛对围气管拔管期不良反应及血流动力的影响

The influence of Kaifen intravenous analgesia on the adverse reactions and hemodynamic in patients undergoing neurosurgical procedures

目的观察凯纷减轻行神经外科手术患者围气管拔管期的不良反应及其对血流动力的影响。方法行神经外科手术的50例患者随机分成凯纷组和对照组,两组患者分别于术毕前凯纷100 mg(10 mL)和30 min给予生理盐水10 mL;拔管后分别单独给予凯纷联合芬太尼及芬太尼自控镇痛。观察记录两组患者围气管拔管期躁动情况、拔管前后10 min及拔管时的血流动力、拔管后患者的镇痛和镇静程度评分及不良反应发生率。结果凯纷组在围气管拔管期的躁动率、SPO(2%)、HR、MAP明显低于对照组(P<0.05);两组患者在拔管镇痛程度无明显变化;凯纷组的镇静程度评分及不良反应发生率低于对照组(P<0.05)。结论凯纷减轻行神经外科手术患者围气管拔管期不良反应,血流动力平稳;联合芬太尼用于患者拔管后镇痛可以减少芬太尼引起的不良反应,提高镇痛质量。

【Objective】 To observe the influence of KaiFen on the side reaction during tracheal extubation and the change of hemodynamic in the patients undergoing neurosurgical procedures.【Methods】 Fifty neurosurgical patients were randomly divided into two groups,i.e.KaiFen and control groups,of 25 patients each.KaiFen 100 mg in 10 mL was intravenously injected about 30 min before the finishing of operations.KaiFen combined fentanyl（in KaiFen froup） was given to the patients after the tracheal extubation for analgesia.During the period of tracheal extubation observe and record restlessness,hemodynamic,analgesia and sedation scores and adverse reactions of two groups of patients.【Results】 The agitation rate,SPO2（%）,HR,MAP in the patients of Kaifen group were significantly lower than the control group and the difference was statistically significant（P 0.05）;There was no significant changes between the groups in the degree of extubation analgesia;The sedation score and incidence of adverse reactions of Kaifen group were significantly lower than the control group and the difference was statistically significant（P 0.05）.【Conclusion】 Kaifen can significantly reduce the adverse reactions and stable hemodynamics in the patients undergoing tracheal extubation.Combined with fentanyl can reduce the adverse reactions caused by fentanyl and improve analgesic quality for patient analgesia after extubation.