您的位置:山东大学 -> 科技期刊社 -> 《山东大学学报(医学版)》

山东大学学报(医学版)

• 论文 • 上一篇    下一篇

瑞芬太尼联合氯诺昔康用于全麻患者苏醒期清醒无痛拔管

张兆航,杜洪玫,张丽,李东亮   

  1. 山东大学齐鲁医院麻醉科, 济南 250012
  • 收稿日期:2007-08-15 修回日期:1900-01-01 出版日期:2008-01-16 发布日期:2008-01-16
  • 通讯作者: 张丽

Remifentanil combined with lornoxicam make extubation comfortable and painless during recovery fromgeneral anesthesia

ZHANG Zhao-hang, DU Hong-mei, ZHANG Li, LI Dong-liang   

  1. Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan 250012, China
  • Received:2007-08-15 Revised:1900-01-01 Online:2008-01-16 Published:2008-01-16
  • Contact: ZHANG Li

摘要: 目的研究瑞芬太尼、氯诺昔康单独或联合应用于全麻患者能否在苏醒期清醒、无痛拔管。方法选取颌面部手术患者60例,美国麻醉医师协会(ASA)分级Ⅰ~Ⅱ级,随机分为4组(n=15)。Ⅰ组,术毕停用瑞芬太尼;Ⅱ组,术毕瑞芬太尼减量至0.05μg/(kg·min),拔管后即停药;Ⅲ组,诱导前20min、术毕前30min分别静注氯诺昔康8mg,瑞芬太尼术毕即停药;Ⅳ组,诱导前20min、术毕前30min分别静注氯诺昔康8mg,术毕瑞芬太尼减量至0.05μg/(kg·min),拔管后即停药。观察记录患者苏醒期有无呛咳、躁动,呼唤睁眼时间、拔管时间,术毕、拔管即刻、拔管后5、10min血压(BP)、心率(HR),拔管后5、10min疼痛评分采用语言评价量表(VRS)。结果Ⅱ、Ⅳ组患者呛咳发生率均明显低于Ⅰ组(P<0.05),睁眼时间和拔管时间均比Ⅰ组稍延长(P<0.05)。Ⅱ、Ⅲ和Ⅳ组拔管即刻、拔管后5min BP和HR均低于Ⅰ组(P<0.05或P<0.01),Ⅲ组和Ⅳ组在拔管后10min BP和HR仍低于Ⅰ组(P<0.05或P<0.01),Ⅳ组患者各时间点的BP、HR无明显差异(P>0.05)。Ⅱ、Ⅲ和Ⅳ组拔管后5min VRS评分均低于Ⅰ组(P<0.05)。Ⅲ组和Ⅳ组拔管后10?min VRS评分低于Ⅰ组或Ⅱ组(P<0.05或P<0.01)。结论瑞芬太尼或氯诺昔康单独应用均可降低全麻苏醒期不良反应;二者联合应用可在患者清醒、无痛条件下安全拔管。

Abstract: To study the efficacy of remifentanil or/and lornoxicam in reducing the adverse effects during recovery from general anesthesia. MethodsSixty ASA Ⅰ to Ⅱ patients aged 18 to 60 years who experienced oral or maxillofacial operations, were divided into four groups(n=15): group Ⅰ (remifentanil infusion was stopped at the end of the operations), group Ⅱ(remifentanil infusion turned into 0.05μg/(kg·min) after the completion of the operations and remained till extubation), group Ⅲ (8 mg lornoxicam was intravenously administered at 20 min before introduction and 30 min before the completion of the operations), and group Ⅳ( remifentanil was used as group Ⅱ and lornoxicam was used as group Ⅲ). Anesthetic induction and maintenance were the same in the four groups. The rate of restlessness and cough during recovery, the time of opening eyes when called, the time of extubation, blood pressure (BP), heart rate (HR) at completion of the operations, extubation, and 5 and 10min after extubation, and the scores of verbal rating scale (VRS) at 5 and 10 min after extubation were determined. ResultsThe cough rate in groups Ⅱ and Ⅳ was lower than that in group Ⅰ(P<0.05), the times of opening eyes and of extubation were also longer than those in group Ⅰ(P<0.05). The BP and HR in groups Ⅱ, Ⅲ and Ⅳ were significantly lower than those in group Ⅰ at extubation and 5 min after extubation (P<0.05 or P<0.01), also they were lower in groups Ⅲ and than in groups Ⅰ at 10 min after extubation (P<0.05 or P<0.01), but they were steady in group Ⅳ during the recovery. The VRS scores were remarkably lower in group Ⅱ, Ⅲ and Ⅳ than in group Ⅰ at 5 min after extubation(P<0.05)and were significantly lower in group Ⅲ and Ⅳ than in group Ⅰ and Ⅱ at 10 min after extubation(P<0.05). ConclusionAdministered remifentanil or lornoxicam can reduce adverse effects during recovery from general anesthesia, and their combination makes extubation comfortable, painless and safe.

Key words: Remifentanil, Lornoxicam, General anesthesia, Pain, Extubation

中图分类号: 

  • R614.2
[1] 郑娟, 李政, 张文静, 袁琳冉, 樊书菠, 刘玉刚, 袁中瑞. Caveolin-1对脑缺血大鼠血管新生的影响[J]. 山东大学学报(医学版), 2015, 53(10): 16-20.
[2] 陈海丽, 顾娇阳, 张文静, 袁琳冉, 郑娟, 袁中瑞. 经典Wnt信号通路在大鼠脑缺血后血管新生中的作用[J]. 山东大学学报(医学版), 2015, 53(4): 31-36.
[3] 陶峰, 郑磊, 蒋嫣, 周取升, 聂鑫. 60例剖宫产手术患者全身麻醉临床观察[J]. 山东大学学报(医学版), 2014, 52(S2): 69-70.
[4] 黄景阳1,杨承慧1,马坤润1,刘曦1,王逸飞1,陈海丽1,刘宝义2,袁中瑞1. HMGB1介导急性高血糖对脑缺血大鼠血-脑脊液屏障的损伤[J]. 山东大学学报(医学版), 2013, 51(9): 17-21.
[5] 李慧1,黄景阳1,陈海丽1,刘宝义2,袁中瑞1. 脑缺血再灌注后大鼠海马Wnt7b的表达[J]. 山东大学学报(医学版), 2013, 51(2): 7-11.
[6] 胡凡艳,王公明,张孟元. 七氟醚预处理对肺叶切除术患者单肺通气诱导氧化应激损伤的影响[J]. 山东大学学报(医学版), 2012, 50(7): 101-.
[7] 李兴华1,类振1,李景新2,孟涛1,张心雨2,于金贵1. 不同静脉麻醉药对大鼠结肠纵形肌收缩活动的影响[J]. 山东大学学报(医学版), 2012, 50(1): 72-75.
[8] 王文,王建光,刘海健,翁浩,徐振兴,谢坤峰. 不同头颈位对LMA-SupremeTM间歇正压通气时口咽漏气压的影响[J]. 山东大学学报(医学版), 2011, 49(11): 125-127.
[9] 吴慧1,2,张丽1. 七氟烷对维库溴铵肌松效应的影响[J]. 山东大学学报(医学版), 2011, 49(5): 81-84.
[10] 孟涛1,张心雨2,李兴华2,于金贵1. 吗啡和芬太尼对心内直视手术患者全身炎性反应和心脏功能影响的比较[J]. 山东大学学报(医学版), 2011, 49(2): 102-105.
[11] 张继如,张焰,朱小莲. 七氟烷静吸复合麻醉控制性降压用于鼻内镜手术的效果[J]. 山东大学学报(医学版), 2010, 48(8): 128-130.
[12] 辛德乾,张孟元,徐艳冰,王公明. 小剂量氯胺酮对心内直视手术患者心肺转流后脑损伤的影响[J]. 山东大学学报(医学版), 2010, 48(3): 134-137.
[13] 谭海波1,于灵芝1,边雯2,张文嘉1,张刚1,张娜1,石秀芳1. 脑缺血再灌注后大鼠氧化水平和神经功能损伤及异丙酚的影响[J]. 山东大学学报(医学版), 2010, 48(1): 41-44.
[14] 张小艳 李刚 王令平. 不同剂量舒芬太尼对脊柱手术患者全麻诱导期血流动力学及血浆皮质醇的影响[J]. 山东大学学报(医学版), 2209, 47(6): 76-79.
[15] 孙宝柱1 ,侯莉莉2 , 张建民1 ,范立霞1 ,易文波1
. 氟比洛芬酯对经鼻蝶入路垂体瘤切除术
患者应激反应的影响
[J]. 山东大学学报(医学版), 2009, 47(03): 106-108.
Viewed
Full text
146
HTML PDF
Just accepted Online first Issue Just accepted Online first Issue
0 0 0 0 0 146

  From Others local
  Times 39 107
  Rate 27% 73%

Abstract
513
Just accepted Online first Issue
0 0 513
  From Others
  Times 513
  Rate 100%

Cited

Web of Science  Crossref   ScienceDirect  Search for Citations in Google Scholar >>
 
This page requires you have already subscribed to WoS.
  Shared   
  Discussed   
No Suggested Reading articles found!