不同剂量盐酸羟考酮注射液对全身麻醉诱导气管插管应激反应的影响

Effects of different dose oxycodone hydrochloride injection on stress response to tracheal intubation anesthesia

目的观察不同剂量盐酸羟考酮注射液对全身麻醉诱导气管插管应激反应的影响。方法选择气管插管全身麻醉手术患者80例,随机分为4组,观察组(O1组、O2组、O3组)和对照组(F组),每组20例。对照组诱导给予注射用芬太尼,其他3组诱导给予不同剂量的盐酸羟考酮,其余诱导药物一致。记录各组入室后10 min(T_0)、诱导后(T_1)、气管插管后1 min(T_2)、3 min(T_3)、5 min(T_4)的心率、平均动脉压(MAP)的变化,并计算心率收缩压乘积(RPP);于T_0、T_2、T_3和T_4时各点抽取患者静脉血,检测其去甲肾上腺素(NE)、肾上腺素(E)及多巴胺(DA)浓度。结果与T_0时比较,F组、O1组HR、MAP、RPP在T_2、T_3、T_4时点均有较大的升高(P<0.05),而O2组、O3组回升平稳,与F组、O1组组间比较差异有统计学意义(P<0.05);与T_0时比较,F组、O1组NE、E、DA在T_2、T_3和T_4各时点明显升高(P<0.05),而O2组、O3组变化不明显,O2组、O3组NE、E、DA在T_2、T_3和T_4时点明显低于F组、O1组,差异有统计学意义(P<0.05)。结论盐酸羟考酮注射液0.25 mg/kg诱导剂量能有效抑制气管插管应激反应。

Objective To observe the effect of different dose oxycodone hydrochloride injection on stress response to tracheal intubation. Methods Anesthesia eighy ASA Ⅰ-Ⅱ physical status patients were randomly divided into four groups （n=20）, then the compared group administer fentanil, the other group administer different dose oxycodone hydrochloride injection. Intubation condition and hemodynamic changes intrachesl intubation were observed. HR , MAP were recorded 10 min after entering operating room （T0）, at the time of induction （T1）, 1 min （T2）, 3 min（T3） and 5 min （T4） after tracheal intubation. RPP was calculated. The venous samples were collected for the measurements of Noradrenaline （NE） adrenaline （E） and dopamine （DA） at T0, T2, T3 and T4. Results Compared with T0, HR, MAP and RPP of group F and O1 were increased （P〈0.05） other two groups the difference between group was statistically significant; NE, E and DA was increased significantly at T2, T3 and T4 as compared to that at T0 in group F and O1 （P〈0.05）,while were not changed remarkably in the O2 and O3 groups, and were significantly lower in group O2 and O3 than in group F and O1, compared with the other two groups the difference between group was statistically significant （P〈0.05）. Conclusion The dosage 0.25 mg/kg of oxycodone hydrochloride injection is effectively suppress the stress response to tracheal intubation.