盐酸纳美芬对行声带息肉摘除术患者麻醉复苏的影响
Effects of nalmefene on the anesthesia resuscitation in patients treated with vocal polyp extirpation
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摘要: 目的：评价盐酸纳美芬对行声带息肉摘除术患者麻醉复苏的临床效果。方法：选择拟行支撑喉镜下声带息肉摘除术患者90例，采用随机数字表法分为3组：盐酸纳美芬组（N1组、N2组）和对照组（C组），各30例。手术结束时N1组、N2组和C组分别静脉注射盐酸纳美芬0.25 μg/kg、0.5 μg/kg和相同容量的0.9%氯化钠注射液。于给药即刻、给药后2 min、给药后10 min及拔管后5 min观察并记录3组患者生命体征的变化和给药后10 min呼吸恢复情况；记录患者的呼之睁眼时间、拔管时间、定向力恢复时间和拔管后15 min时氧分压和二氧化碳分压情况；记录拔管后5、30、60、120 min时的镇静评分（Ramsay评分）、疼痛评分（VAS评分）以及术后不良反应的发生情况。结果：与C组比较，N1、N2组给药后10min时患者呼吸恢复率升高，呼之睁眼时间、拔管时间、定向力恢复时间缩短，拔管后15min时氧分压升高，二氧化碳分压、术后恶心呕吐的发生率均降低（P < 0.05~P < 0.01），而N1组与N2组比较差异均无统计学意义（P > 0.05）。N1、N2组在拔管后5、30、60、120 min时意识状态均优于C组（P < 0.01），而N1组与N2组差异均无统计学意义（P > 0.05）。3组患者在各个时间点的生命体征以及在拔管后各时间点VAS评分差异均无统计学意义（P > 0.05）。3组患者恶心呕吐及拔管后呼吸抑制发生率差异均有统计学意义（P < 0.05）。结论：盐酸纳美芬用于支撑喉镜下声带息肉摘除术，患者麻醉复苏效果好，且术后不良反应发生率低，临床值得推广。Abstract: Objective: To evaluate the clinical effects of nalmefene on anesthesia resuscitation in patients treated with vocal cord polypectomy.Methods: Ninety patients scheduled by vocal cord polypectomy were randomly divided into the control group(C group) and nalmefene group,and the nalmefene group were subdivided into the N1 and N2 group according to digital number table method(30 cases each group).The 0.9% of sodium chloride injection,0.25 μg/kg and 0.5 μg/kg of nalmefene were injected into the C,N1 and N2 group at end of the surgery.The changes of vital signs after 0,2 min and 10 min of administration,and after 5 min of extubation,and the breath recovery at T2 in 3 groups were recorded.The time of eye opening,extubation and orientation recovery,and the PaO2 and PaCO2 after 15 min of extubation were recorded.The scores of Ramsay scale,VAS scale and postoperative adverse reaction were recorded after 5,30,60 and 120 min of extubation.Results: Compared with the C group,the incidence of breathing recovery in N1 and N2 group significantly increased after 10 min of administration,and the time of eye opening,extubation and orientation recovery significantly shortened.The PaO2,PaCO2 and incidence of postoperative nausea and vomiting in 3 groups significantly decreased after 15 min of extubation(P < 0.05 to P < 0.01),and the differences of whose between N1 and N2 group were not statistically significant(P > 0.05).The consciousness in N1 and N2 group after 5,30,60 and 120 min of extubation were better than that in C group(P < 0.05),and the difference of which between N1 and N2 group was not statistically significant(P > 0.05).The differences of vital signs and VAS scale at each time-point between 3 groups were not statistically significant(P > 0.05).The differences of the incidences of nausea and vomiting,and respiratory depression after extubation between three groups were statistically significant(P > 0.05).Conclusions: The treatment of vocal cord polypectomy with nalmefene has better anesthesia recovery effects and low incidence of side action,which is worthy of promotion.
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Key words:
- anesthesia recovery /
- nalmefene /
- vocal cord polypectomy /
- suspension laryngoscopy
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