摘要
目的:比较等效镇痛剂量芬太尼、瑞芬太尼和舒芬太尼对维吾尔族患者镇静时生命体征的影响。方法:选择新疆伊宁市人民医院80例拟择期行气管插管全麻下手术的患者,采用数字表法随机分为对照组(D组)、芬太尼组(F组)、瑞芬太尼组(R组)、舒芬太尼组(S组)4组各20例。F、R、S组静脉30 s内分别给予芬太尼2μg·kg^(-1)、瑞芬太尼2μg·kg^(-1)、舒芬太尼0.2μg·kg^(-1),D组给予等容量生理盐水10 ml。观察给药前(T0)及给药后1 min(T1)、3 min(T2)、5 min(T3)、10 min(T4)5个时间点患者生命体征及不良反应发生情况。结果:与D组比较,Ramsay评分F、R组在T2~T3、S组在T2~T4存在明显差异;与F、R组比较,S组在T4显著降低。与D组比较,F、R组呼吸频率在T2~T3、S组在T2~T4存在明显差异(P<0.05)。心率R组在T2~T3较D组有明显差异。不良反应:3个实验组间F组恶心呕吐、R组心率<50次·min^(-1)、S组呼吸抑制的发生率分别较其余两组明显增加。结论:上述3种等效镇痛剂量阿片类药物用于维吾尔族患者镇静时,芬太尼恶心呕吐的发生率较高,瑞芬太尼对患者心率的影响较大,舒芬太尼对意识、呼吸的抑制作用最明显。
Objective: To examine the different effects produced by equivalent analgesic doses of fentanyl,remifentanil and sufentanilin on vital signs in Uigur patients. Methods: Eighty patients undergoing selective operation in Yining hospital of Xinjiang Uygur Autonomous Region were randomly assigned into four groups with 20 in each group: control group( group D); group remifentanil( group R); group sufentanil( group S) and group fentanyl( group F). Remifentanil 2 μg·kg^-1,sufentanil 0. 2 μg·kg^-1and fentanyl 2 μg·kg^-1in normal saline10 ml were infused intravenously over 30 s in group R,S and F respectively. MAP,HR,SPO_2,RR and the score of Ramsay were recorded before( T0),and 1( T1),3( T2),5( T3) and 10( T4) min. Besides,the incidences of bucking,pruritus,muscle rigidity,nausea and vomiting,respiratory depression( Sp O_2 〈90% or RR ≤ 8 sub per minute),MAP〈 65 mm Hg,and HR 〈50 sub per minute were also monitored. Results: Ramsay score: Compared with group D,the scores in group F,R at T2,T3 and group S at T2,T4 declined significantly,so did the scores in group S at T4 compared with group F and R. Respiratory: RRs in group F,R were lower than those in group D at T2,T3,but they were the same as those in group S at T2,T4. Circulation: HR in group R was apparently lower than that in group D at T2,T4. Side reactions: Severe nausea and vomiting,highest HR decrease and prominent respiratory depression were respectively caused by fentanyl,remifentanil and sufentanil. Conclusion: Fentanyl can cause the highest incidence of nausea and vomiting,remifentanil has the greatest impact on HR and sufentanil generates prominent inhibitory effects on consciousness and respiratory.
出处
《现代医学》
2016年第2期187-190,共4页
Modern Medical Journal
关键词
镇痛药
阿片类
生命体征
维吾尔族
不良反应
analgesics
opioid
vital signs
Uigur nationality
adverse effects