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关腹前应用盐酸羟考酮对全身麻醉下妇科腹腔镜手术患者血流动力学及镇静作用的影响
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| 篇名： | 关腹前应用盐酸羟考酮对全身麻醉下妇科腹腔镜手术患者血流动力学及镇静作用的影响 |
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| 摘要： | 目的：探讨关腹前应用盐酸羟考酮对全身麻醉下妇科腹腔镜手术患者血流动力学及镇静作用的影响。方法：选取拟行妇科腹腔镜手术患者82例，分为对照组和观察组，各41例。两组患者均采用气管插管全身麻醉，观察组患者于关腹前静脉注射盐酸羟考酮注射液3 mg，对照组患者则给予等量0.9％氯化钠注射液。观察两组患者拔管即刻（T1）、拔管后5 min（T2）、拔管后30 min（T3）时的收缩压（SBP）、心率（HR）及镇静（Ramsay）评分，记录两组患者自主呼吸恢复时间、苏醒时间、拔管时间及咳呛躁动发生情况。测定两组患者术后2、4、6、24 h视觉模拟（VAS）评分，观察两组患者不良反应发生情况。结果：T1、T2时，两组患者SBP、HR比较，差异无统计学意义（P＞0.05）；T3时，对照组患者SBP、HR均显著升高，且显著高于观察组，差异有统计学意义（P＜0.05）。T1时，两组患者Ramsay评分比较，差异无统计学意义（P＞0.05）；T2、T3时，观察组患者Ramsay评分显著升高，且显著高于对照组，差异有统计学意义（P＜0.05）。两组患者拔管时间比较，差异无统计学意义（P＞0.05）；观察组患者自主恢复时间、苏醒时间均显著短于对照组，差异有统计学意义（P＜0.05）。观察组患者无咳呛、躁动0级发生率显著高于对照组，中重度咳呛、2～3级躁动发生率显著低于对照组，差异有统计学意义（P＜0.05）。术后2、4、6、24 h，观察组VAS评分显著低于对照组，差异有统计学意义（P＜0.05）。观察组患者不良反应发生率为7.3％，显著低于对照组的51.2％，差异有统计学意义（P＜0.05）。结论：关腹前应用盐酸羟考酮对全身麻醉妇科腔镜手术患者镇痛、镇静效果好，安全性高，患者血流动力学稳定、苏醒速度快。 |
| ABSTRACT： | OBJECTIVE： To investigate the effects of using oxycodone hydrochloride before abdominal closure on hemodynamics and sedation in gynecological patients underwent general anesthesia of laparoscopic surgery. METHODS： Eighty-two patients undergoing gynecological laparoscopic surgery were selected and divided into control group and observation group according to treatment order， with 41 cases in each group. Both group were operated under general anesthesia with endotracheal intubation. Observation group was given oxycodone hydrochloride intravenously 3 mg， and control group was given constant volume of 0.9％ Sodium chloride injection before abdominal closure. SBP， HR and Ramsay score were observed in 2 groups during extubation （T1）， 5 min after extubation （T2）， 30 min after extubation （T3）. The spontaneous breathing recovery time， recovery time， extubation time and the occurrence of cough and agitation were recorded in 2 groups. 2， 4， 6 and 24 h after surgery， VAS scores were determined in 2 groups. The occurrence of ADR was observed in 2 groups. RESULTS： At T1 and T2， there was no statistical difference in SBP and HR between 2 groups （P＞0.05）； at T3， SBP and HR of control group were significantly increased and higher than observation group， with statistical significance （P＜0.05）； At T1， there was no statistical significance in Ramsay score between 2 groups （P＞0.05）； at T2 and T3， Ramsay score of observation group was significantly improved and higher than control group， with statistical significance （P＜0.05）. There was no statistical significance in extubation time between 2 groups （P＞0.05）. The spontaneous breathing recovery time and recovery time of observation group were significantly shorter than control group， with statistical significance （P＜0.05）. The incidence of no cough and agitation at 0 level in observation group were significantly higher than in control group； and the incidence of median and severe cough， agitation at 2-3 level were significantly lower than control group， with statistical significance （P＜0.05）. 2 h， 4 h， 6 h and 24 h after operation， VAS scores of observation group were significantly lower than control group， with statistical significance （P＜0.05）. The incidence of ADR in observation group was 7.3％， which was significantly lower than 51.2％ of control group， with statistical significance （P＜0.05）. CONCLUSIONS： The application of oxycodone hydrochloride before abdominal closure shows good analgesic and sedative effects in gynecological laparoscopic surgery under general anesthesia with good safety， can keep hemodynamics stable and quick recovery. |
| 期刊： | 2017年第28卷第5期 |
| 作者： | 李妮娟，吴畏 |
| AUTHORS： | LI Nijuan，WU Wei |
| 关键字： | 羟考酮；腹腔镜手术；全身麻醉；镇痛；恢复 |
| KEYWORDS： | Oxycodone； Laparoscopic surgery； General anesthesia； Analgesia； Recovery |
| 阅读数： | 282 次 |
| 本月下载数： | 3 次 |
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