摘要
目的 观察芬太尼、曲马多用于减轻麻醉苏醒期及拔除气管导管时心血管反应的作用。方法 30例ASA Ⅰ～Ⅱ级、择期行上腹部手术患者随机分为 A、B、C三组,每组 10例,接受气管插管、静吸复合全麻。缝合腹膜时三组患者分别静注生理盐水10 ml、芬太尼1 μg/kg和曲马多 1 mg/kg。术毕待达到可接受的拔管标准时拔除气管导管。拔管前1分钟记录MAP、HR;拔管后每隔1分钟记录MAP、HR,直至技管后5分钟;静注干预药物至拔管时间。结果 拔管后数分钟内,A组MAP、HR较拔管前显著升高(P<0.05),之后又下降;B、C两组MAP、HR无显著变化(P>0.05),而与A组相比,有显著性差异(P<0.05)。A、B和C三组静注干预药物至拔管时间,后两者明显较前者长(P<0.05)。结论 在上腹部手术,缝合腹膜时静注芬太尼1μg/kg或曲马多1 mg/kg,均可显著减轻麻醉苏醒期及拔除气管导管时的心血管反应,但应注意对呼吸功能的影响。
Objective To observe the effects of intravenous tramadol and fentanyl on reducing cardiovascular response to emergence from awake period of anesthesia and tracheal extubation. Methods 30 cases of ASA Ⅰ - Ⅱpatients, which were scheduled for selective surgery of upper abdomen were randomly divided into three groups and received a standard general anesthesia consisting of fentanyl, propofol, rocuronium and isoflurane. During the peri-toneal suture, the normai saline (Group A), fentanyl (Group B) and tramadol (Group C) were given respectively by I. V. injection. Postoperative tracheal extubation was performed when acceptable criteria was achieved. Non-invasive mean arterial pressure (MAP) and heart rate (HR) were recorded at l min interval from the end of operation. Results Within the several minutes after extubation, the Group A was more increased than before extubation in the MAP and HR and then it was declined. In the Group B and C, the MAP and HR were no variation significantly (P> 0. 05), and compared with Group A, it had a difference obviously (P < 0. 05). Conclusion Intravenous tramadol and fentanyl can effectively relieve hemodynamic response to emergence from awake period of anesthesia and tracheal extubation, but the respiratory effects of tramadol must be attended carefully.
出处
《岭南现代临床外科》
2002年第3期175-176,共2页
Lingnan Modern Clinics in Surgery
关键词
曲马多
芬太尼
拔管
心血管反应
Tramadol
Fentanyl
Extubation
Cardiovascular response
