不同剂量羟考酮在全身麻醉诱导期气管插管中的效果对比

Effect contrast of different doses of Oxycodone during the anesthesia induction of tracheal intubation

目的研究并比较不同剂量羟考酮在全身麻醉诱导期间气管插管中的麻醉效果。方法选取2016年1月~2017年10月在广州医科大学附属第六医院(清远市人民医院)拟行经口气管插管全身麻醉择期骨科手术的75例患者作为研究对象,按照随机数字表法将其分为低剂量组、中剂量组、高剂量组,每组各25例。低剂量组、中剂量组、高剂量组患者分别静脉注射0.20、0.25、0.30 mg/kg的羟考酮进行麻醉诱导。比较三组患者不同时间点的肾上腺素浓度、去甲肾上腺素浓度以及生命体征指标水平。结果三组患者T_1时的平均动脉压、心率均低于本组T_0时,差异有统计学意义(P<0.05)。低剂量组患者在T_2、T_3、T_4时的肾上腺素、去甲肾上腺素、平均动脉压、心率均高于本组T_0时以及中剂量组、高剂量组,差异有统计学意义(P<0.05)。中剂量组、高剂量组患者在T_2、T_3、T_4时的肾上腺素、去甲肾上腺素、平均动脉压、心率与本组T_0时比较,差异无统计学意义(P>0.05)。中剂量组患者在T_2、T_3、T_4时的肾上腺素、去甲肾上腺素、平均动脉压、心率与高剂量组比较,差异无统计学意义(P>0.05)。结论对气管插管全身麻醉患者,采用0.25 mg/kg羟考酮进行麻醉诱导,可达到与高剂量羟考酮相当的麻醉效果,可有效减轻应激反应,稳定生命体征,值得临床推广应用。

Objective To study and compare the anesthetic effect of different doses of Oxycodone during the anesthesia induction of tracheal intubation.Methods A total of 75 patients who received of orthopedics surgery for general anesthesia of trachea intubation in the Sixth Hospital Affiliated to Guangzhou Medical University, Qingyuan People＇s Hospital from January 2016 to October 2017 were selected as subjects.According to the random number table method, they were divided into low dose group,middle dose group and high dose group,with 25 patients in each group.The low dose group,middle dose group and high dose group were intravenously injected with 0.20,0.25,0.30 mg/kg Oxycodone anesthesia respectively.The concentration of adrenaline,norepinephrine and the indicators of vital signs at different time points in three groups were compared.Results The mean arterial pressure and heart rate in the T1 of the three groups were lower than those in the T0,and the differences were statistically significant （P 〈0.05）.In T2,T3 and T4,the epinephrine,norepinephrine,mean arterial pressure and heart rate of patients in low dose group were higher than T0, medium dose group and high dose group,the differences were statistically significant （P〈0.05）.There was no statistically significant difference in epinephrine,norepinephrine,average arterial pressure and heart rate in the middle and high dose group at T2,T3 and T4 cornpared with To （P〉0.05）.The epinephrine,norepinephrine,average arterial pressure and heart rate at T2,T3 and T4 in the middle dose group were compared with the high dose group,and the differences were not statistically significant （P〉0.05）.Conclusion In patients with general anesthesia in tracheal intubation,the anesthesia effect of 0.25 mg/kg of Oxycodone for anesthesia induction can reached the anesthesia effect of high dose of Oxycodone,it can effectively relieve stress response and stabilize the vital signs.It s worthv of clinic aonlication