喷他佐辛在健忘镇痛慢诱导麻醉中对呼吸功能的影响

Effects of pentazocine on respiratory function during slow induction of anesthesia

目的观察喷他佐辛在健忘镇痛慢诱导麻醉中对呼吸功能的影响。方法 40例择期腹腔镜手术患者,美国麻醉师协会(ASA)Ⅰ或Ⅱ级,随机分为对照组芬太尼组(F组,n=20)、喷他佐辛组(P组,n=20)。两组病人均在局麻下行桡动脉穿刺置管,静注咪达唑仑0.03 mg/kg,随后分别静注芬太尼2μg/kg,喷他佐辛0.8 mg/kg。给药后经环甲膜穿刺、喉部表面麻醉,喉麻3 min时行气管内插管。记录两组患者各观察时间点的动脉血氧饱和度(SaO 2),动脉血氧分压(PaO 2),二氧化碳分压(PaC O2)值。结果两组患者各观察时间点PaO 2、SaO 2与给药前相比值增大,差异有统计学意义(P<0.05)。芬太尼组PaC O2各观察时间点与给药前相比值升高,但平均值均在正常范围内变化,具有统计学差异(P<0.05);而喷他佐辛组PaC O2各观察时间点与给药前相比值略微升高,在统计学上无显著差异(P>0.05)。结论 0.8 mg/kg喷他佐辛复合咪达唑仑用于健忘镇痛慢诱导麻醉中可有效抑制气管插管应激反应且不良反应发生率低。

Objective To investigate the effect of pentazocine on respiratory function in slow induction of anesthesia. Methods Forty ASA I - II patients were divided into two groups. The first, all the patients were dealt with radial artery cannulation under local anesthesia. The second, anesthesia was induced with midazolam 0.03 mg ~ kg -1 in both groups, and pentazocine 0.8 mg/kg （ i. v. ） was given in pentazocine group or fentanyl 2 μg/kg （i. v. ） in fentanyl group. Five minutes later, 2ml of 1% decicaine was administered by cricothyroid membrane puncture to facilitate the intubation. The respiratory indexes （ SaO2 , PaO2, PaCO2, SpO2 ）, circulatory indexes （ HR, BP, BIS） and sedation level were measured at each observation points. Results All the patients＇PaO2, SaO2 for each observation point were higher evidently compared with TO （ before injection of drugs） and had significant difference （ P 〈 0.05 ）. The PaCO2 of fentanyl group increased after injection of drugs and had signiticant difference （ P 〈 0.05 ）, but no significant difference in pentazocine group （ P 〉 0. 05 ）. Conclusion Because of strong analgesia effect and weak respiratory inhibition, Pentazocine combined with midazolam were suitable for anesthesia induction in the slow induction of anesthesia.