林可霉素联合阿芬太尼对自主呼吸的影响

Effects of lincomycin combined with alfentanil on spontaneous respiration

目的探讨林可霉素联合阿芬太尼对自主呼吸的影响。方法选取2020年5—7月于本院行外科手术的40例患者作为研究对象,随机分为实验组与对照组,每组20例。实验组于手术切皮前30 min给予林可霉素0.6 g缓慢静脉滴注,对照组给予安慰剂。两组均采用臂丛神经阻滞麻醉,无不良反应后均于切皮前静脉缓慢注射阿芬太尼5μg/kg辅助镇痛,比较两组阿芬太尼静脉注射前(T0)、静脉注射后2 min(T1)、5 min(T2)、10 min(T3)、15 min(T4)、20 min(T5)各时间点呼吸频率与血氧饱和度变化及辅助呼吸发生率。结果T0时,两组呼吸、血氧饱和度比较差异无统计学意义;T1、T2时,实验组呼吸频率、血氧饱和度均明显低于对照组,差异有统计学意义(P<0.05);T3、T4时,实验组呼吸频率、血氧饱和度回升,但仍低于对照组(P<0.05);T5时,两组呼吸频率、血氧饱和度比较差异无统计学意义。实验组辅助呼吸发生率高于对照组,差异有统计学意义(P<0.05)。结论林可霉素具有明显增强和延长阿芬太尼呼吸抑制作用,两药合用时需密切监护患者呼吸频率及血氧饱和度,并做好辅助呼吸措施准备。

Objective To investigate the effects of lincomycin combined with alfentanil on spontaneous respiration.Methods 40 patients who underwent surgery in our hospital from May to July 2020 were selected as the research subjects and they were randomly divided into the experimental group and the control group,with 20 cases in each group.The experimental group was given slow intravenous drip of lincomycin 0.6 g 30 min before surgical incision,and the control group was given placebo.Both groups were anesthetized by brachial plexus block,and after no adverse reactions,alfentanil 5μg/kg was slowly injected intravenously before skin incision as adjuvant analgesia,the rate of respiration,the oxygen saturation and the incidence of assisted respiration were compared between the two groups before intravenous injection of alfentanil(T0),2 min(T1),5 min(T2),10 min(T3),15 min(T4)and 20 min(T5)after intravenous injection.Results At T0,there was no significant difference in respiration and blood oxygen saturation between the two groups;at T1 and T2,the rate of respiration and blood oxygen saturation of the experimental group were significantly lower than those of the control group,and the difference was statistically significant(P<0.05);at T3 and T4,the respiration rate of and blood oxygen saturation in the experimental group recovered,but were still lower than those in the control group;at T5,there was no significant difference in the respiration and blood oxygen saturation between the two groups.The incidence of assisted breathing in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Lincomycin can significantly enhance and prolong the respiratory depression effect of alfentanil,it is necessary to closely monitor the patients'respiratory rate and blood oxygen saturation and prepared for assisted breathing when the two drugs are combined.