盐酸羟考酮在糖尿病患者经鼻插管健忘镇痛慢诱导中的应用
Application of oxycodone in diabetics treated with forgetfulness analgesia slow induction by transnasal catheter
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摘要: 目的：观察静脉注射0.1 mg/kg盐酸羟考酮用于糖尿病患者慢诱导经鼻气管插管对血流动力学、应激反应的影响。方法：随机选择80例ASAⅠ～Ⅱ级且年龄38～60岁的糖尿病患者，随机双盲分为盐酸羟考酮组（O组）40例和芬太尼组（F组）40例。O组盐酸羟考酮0.1 mg/kg静脉注射；F组枸橼酸芬太尼1 μg/kg静脉注射。测定2组入室（T0）和气管导管过鼻后孔（T1）、插管即刻（T2）、插管后3 min（T3）、插管后10 min（T4）的收缩压（SBP）、舒张压（DBP）、心率（HR）和各时点的肾上腺素和去甲肾上腺素。结果：SBP水平，与术前比较，2组在术中（T1和T2）上升（P<0.05），术后（T3和T4）下降（P<0.05）；2组比较，F组在术中升高幅度高于O组（P<0.05）；DBP 水平，O组在术中变化不明显（P>0.05），术后有所下降（P<0.05），F组术中上升（P<0.05），术后下降（P<0.05）；2组HR均出现术中上升（P<0.05），术后下降的现象（P<0.05），但F组HR升高幅度大于O组（P<0.05）；比较不同时间点的肾上腺素和去甲肾上腺素水平，2组均表现为T2时间点后上升趋势（P<0.05），且F组上升幅度高于O组（P<0.05～P<0.01）。结论：0.1 mg/kg盐酸羟考酮用于糖尿病患者健忘镇痛慢诱导气管插管中，维持了血流动力学稳定，显著抑制了机体应激反应，增加了2型糖尿病患者非心脏手术围术期安全性。Abstract: Objective: To investigate the effects of intravenous injection of 0.1 mg/kg of oxycodone on the hemodynamics and stress response in diabetics treated with forgetfulness analgesia slow induction by transnasal catheter.Methods: Eighty stage ASA Ⅰ to Ⅱ diabetics(38 to 60 years old) were randomly divided into the oxycodone group(group O) and fentanyl group(group F)(40 cases each group).The group O and group F were treated with 0.1 mg/kg of oxycodone and 1 μg/kg of fentanyl by intravenous injection,respectively.The levels of SBP,DBP,HR,Epinephrine and Norepinephrine in two groups were measured before anesthesia induction(T0),tracheal tube through choana(T1),at the time of intubation(T2),after 3 min of intubation(T3) and after 10 min of intubation(T4).Results: Compared before operation,the SBP level in two group increased at T1 and T2(P<0.05),and decreased at T3 and T4(P<0.05).The increasing degree in group F was higher than that in group O(P<0.05).In group O,the SBP level did not obviously change during operation(P>0.05),and decreased after operation(P<0.05).In F group,the SBP level increased during operation(P<0.05),and decreased after operation(P<0.05).In two groups,the HR level increased during operation(P < 0.05),decreased after operation(P<0.05),and the increasing degree of HR in group F was higher than that in group O(P<0.05).The levels of Epinephrine and Norepinephrine in two group increased after T2(P<0.05),and the increasing degree of which in group F was higher than that in group O(P<0.05 to P<0.01).Conclusions: The 0.1 mg/kg of oxycodone in diabetics treated with forgetfulness analgesia slow induction by transnasal catheter can maintain the hemodynamic stability,significantly inhibit the stress response of body,and increase the safety of patients with type 2 diabetes during noncardiac surgery.
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Key words:
- diabetes /
- oxycodone /
- slow induction /
- hemodynamics /
- stress response
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