羟考酮用于宫外孕手术患者全麻诱导插管的临床研究

Clinical Study of Oxycodone in General Anesthesia Induced Intubation in Patients Undergoing Ectopic Pregnancy

目的探讨羟考酮用于腹腔镜下宫外孕手术患者全麻诱导插管的安全性和有效性。方法选择2018年4月~12月在我院择期行腹腔镜下宫外孕手术患者90例。采用随机数字表法分为S组(舒芬太尼0.2μg/kg)、01组(羟考酮0.15mg/kg)、02组(羟考酮0.2mg/kg),每组30例。注射实验药物观察5min后给予丙泊酚2mg/kg,顺阿曲库铵0.15mg/kg诱导插管,比较三组插管时间、手术时间;注射实验药物前(T1),气管插管前(T2),插管后1min(T3),插管后7.5min(T4)的MAP、HR、SpO2、BIS以及不良反应总发生率。结果三组T2时点MAP、HR、BIS低于T1时点,SpO2高于T1时点,差异有统计学意义(P<0.05);T3时点HR、SpO2高于T1时点,MAP、HR、SpO2高于T2时点,BIS高于T2时点、但低于T1时点,差异有统计学意义(P<0.05);T4时点MAP、BIS低于T1时点,HR、SpO2高于T1时点,MAP、HR、BIS高于T2时点,MAP、HR低于T3时点,差异有统计学意义(P<0.05)。01组不良反应总发生率低于S组和02组,差异具有统计学意义(P<0.05);02组不良反应总发生率于S组,差异具有统计学意义(P<0.05)。结论对于宫外孕患者,采用0.15mg/kg羟考酮进行麻醉诱导,不仅可达到与高剂量的舒芬太尼和羟考酮相当的麻醉效果,还可有效减轻插管期间的呛咳及心血管不良事件的发生。

Objective To investigate the safety and efficacy of oxycodone in general anesthesia-induced intubation in patients undergoing laparoscopic ectopic pregnancy.Methods 90 patients undergoing laparoscopic ectopic pregnancy in our hospital from April to December 2018 were enrolled. The random number table method was divided into S group (suffentanil 0.2 μg/kg), 01 group (oxycodone 0.15 mg/kg), 02 group (oxycodone 0.2 mg/kg), 30 cases in each group. 5 minutes after injection of experimental drugs, propofol 2 mg/kg and cis-atracurium 0.15 mg/kg were used to induce intubation. Three groups of intubation time and operation time were compared. Before injection of experimental drug (T1), tracheal intubation was performed. Pre-(T2), 1 min (T3) after intubation, MAP, HR, SpO2, BIS and total incidence of adverse reactions at 7.5 min (T4) after intubation.Results The MAP, HR, and BIS of the three groups of T2 were lower than the T1 point, when SpO2 is higher than T1, the difference is statistically significant (P<0.05);HR, SpO2 is higher than T1 at T3, MAP, HR, and SpO2 are higher than T2, BIS is higher than T2, but low at T1, the difference was statistically significant (P<0.05);MAP, BIS was lower than T1 at T4, HR, SpO2 was higher than T1, MAP, HR, BIS were higher than T2, MAP, When HR was lower than T3, the difference was statistically significant (P<0.05). The total incidence of adverse reactions in the 01 group was lower than that in the S group and the O2 group, the difference was statistically significant (P<0.05);the total incidence of adverse reactions in group 02 was in S group, the difference was statistically significant (P<0.05).Conclusion For patients with ectopic pregnancy, anesthesia induction with 0.15 mg/kg oxycodone can not only achieve the anesthetic effect comparable to high doses of sufentanil and oxycodone, but also effectively reduce cough and cardiovascular during intubation. The occurrence of adverse events.