纳美芬在小儿全身麻醉后复苏中的应用研究

Research on application of nalmefene in recovery after general anesthesia in children

目的观察小剂量纳美芬在小儿麻醉后复苏中拮抗阿片类药物呼吸抑制以及促进意识恢复的有效性和安全性。方法将90例择期行腹腔镜下内环口高位结扎的学龄前儿童分为纳美芬组、纳洛酮组和对照组,每组30例。患儿行常规芬太尼复合全身麻醉,术毕按分组情况静脉注射纳美芬0.25μg/kg、纳洛酮1μg/kg或生理盐水0.25mL/kg,随后记录患儿的睁眼时间、拔管时间、呼吸恢复率、镇静评分、疼痛评分等。结果纳美芬组和纳洛酮组的睁眼时间、拔管时间均短于对照组,呼吸恢复率高于对照组,差异均有统计学意义(P<0.05),3组患儿均无严重不良事件发生。结论小剂量纳美芬和纳洛酮均能安全、有效地应用于小儿全身麻醉后麻醉复苏,快速解除芬太尼引起的呼吸抑制,并促进意识恢复。

Objective To observe the effectiveness and security of small dose nalmefene on antagonizing respiratory depression caused by opioid drugs and promoting consciousness restoration in children postanesthesia recovery.Methods Ninety preschool age children patients undergoing elective laparoscopic internal orifice high ligation were divided into the nalmefene group,naloxone group and control group,30 cases in each group.Then the children patients conducted routine fentanyl combined general anesthesia,at the end of operation,intravenous injected of nalmefene 0.25μg/kg,naloxone 1μg/kg or normal saline 0.25 mL/kg were given according to the grouping situation.Then the eye opening time,extubation time,respiratory recovery rate and sedation score were recorded.Results The eye opening time and extubation time in the nalmefene group and naloxone group were shorter than that in the control group,the difference was statistically significant(P<0.05).No serious adverse event occurred in 3 groups.Conclusion Small dose nalmefene and naloxone can be safely and effectively applied in children postanesthesia recovery,rapidly relieve respiratory depression caused by fentanyl and promote consciousness recovery.