小剂量瑞芬太尼预防拔管期心血管反应的有效性及安全性

Small Doses Fentanyl in Preventing Decannulation Period of Efficacy and Safety of Cardiovascular Reaction

目的:探讨小剂量瑞芬太尼预防拔管期心血管反应的有效性及安全性,为预防拔管期心血管反应提供参考依据。方法:选取100例全麻下手术患者,以数字表格法分为观察组与对照组各50例,观察组从手术结束时给予瑞芬太尼0.10μg/kg·min泵注直至拔管结束,对照组不给予任何药物,观察两组麻醉前(T1)、拔管时(T2)、拔管后3min(T3)、拔管后5min(T4)时的心率(HR)、收缩压(SBP)、舒张压(DBP)变化,麻醉恢复指标变化及不良反应发生情况。结果:在T2时点时HR、SBP、DBP明显高于T1时点,T3、T4时点有所下降,组内比较不同时点HR、SBP、DBP差异具有统计学意义(P<0.05),其中T2时点、T3时点与T1时点比较差异具有统计学意义(P<0.05),T2时点、T3时点观察组HR、SBP、DBP明显低于对照组(P<0.05);观察组与对照组在自主呼吸恢复时间、拔管时间、苏醒时间方面比较差异无统计学意义(P>0.05),观察组不良反应发生率为6.00%,对照组为28.00%,两组比较差异具有统计学意义(P<0.05)。结论:在拔管期使用小剂量瑞芬太尼有利于预防拔管期心血管反应,疗效肯定,不良反应发生率低。

Objective:to explore the small dose of fentanyl of Rayleigh wave in preventing decannulation period of cardiovascular response efficacy and safety,to prevent cardiovascular response to provide the reference basis decannulation period.Methods:selected 100patients with surgery under general anesthesia,in digital form method divided into observation group and control group 50cases each,at the end of the observation group from surgery give her fentanyl mu g/kg,0.10min until the end of tube drawing pump injection contrast gives no drugs,observe the two groups before anesthesia(T1),extubation(T2),3min after extubation(T3),5min after extubation(T4),heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),anesthesia recovery index change and adverse reactions occur.Results:when T2 time HR,SBP,DBP is significantly higher than T1 time,T3,T4 point,by comparing different points in the group HR,SBP,DBP,difference has statistical significance(P<0.05),including T2 time,T3 point compared with T1 time differences statistically significant(P<0.05),T2,T3,HR,SBP,DBP point observation group was obviously lower than control group(P<0.05);Observation group and control group in the spontaneous breathing recovery time and extubation time,awakening time in comparison there was no statistically significant difference(P>0.05),the observation group,the incidence of adverse reactions was 6.00%,control group was 28.00%,compared two groups statistically significant difference(P<0.05).Conclusion:in decannulation period using the small dose fentanyl is beneficial to prevent decannulation period of cardiovascular reaction,curative effect,low incidence of adverse reactions.