纳布啡辅助抑制腹腔镜胆囊切除术麻醉诱导时舒芬太尼诱发呛咳反应的效果

doi:10.3969/j.issn.1671-7171.2025.02.011

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1211 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要【目的】探讨纳布啡辅助抑制腹腔镜胆囊切除术(LC)麻醉诱导时舒芬太尼诱发呛咳反应的效果。【方法】82例行LC的患者,随机分为观察组与对照组,每组41例。两组患者均采用舒芬太尼麻醉诱导,麻醉诱导前10 min,对照组静脉注射0.01 mg/kg盐酸戊乙奎醚,观察组静脉注射0.01 mg/kg盐酸戊乙奎醚+0.1 mg/kg 纳布啡。比较两组麻醉中呛咳反应发生情况,血流动力学和应激指标变化,疼痛情况及不良反应。【结果】观察组呛咳反应发生率低于对照组(P<0.05),两组呛咳反应持续时间比较,差异无统计学意义(P>0.05)。两组患者注射舒芬太尼后2 min(T₂)时平均动脉压(MAP)、心率(HR)低于注射舒芬太尼前10 min(T₀)、注射后1 min(T₁)时(P<0.05),且T₁时低于T₀时(P<0.05);观察组T₁、T₂时MAP、HR均高于对照组(P<0.05)。两组患者术后4 h(T₄)、术后24 h(T₅)时疼痛数字等级评分(NRS)低于苏醒时(T₃)时(P<0.05),T₅时NRS评分低于T₄时(P<0.05);但两组患者各时刻NRS评分比较,差异无统计学意义(P>0.05)。术后24 h,两组肾上腺素、去甲肾上腺素水平较术前均升高(P<0.05),但两组比较,差异均无统计学意义(P>0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】纳布啡辅助抑制LC麻醉诱导时舒芬太尼诱发的呛咳反应效果确切,对患者血流动力学影响较小,可减轻患者术后疼痛,且安全可靠。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	宋佩

关键词 ：胆囊切除术, 腹腔镜, 纳布啡, 舒芬太尼, 麻醉

Abstract：【Objective】To investigate the effect of nalbuphine in suppressing the cough reflex induced by sufentanil during anesthesia induction for laparoscopic cholecystectomy (LC).【Methods】A total of 82 patients undergoing LC were randomly divided into the observation group and the control group, with 41 patients in each group. Both groups were administered sufentanil for anesthesia induction. Ten minutes before induction, the control group received 0.01 mg/kg of penehyclidine hydrochloride intravenously, while the observation group received 0.01 mg/kg of penehyclidine hydrochloride plus 0.1 mg/kg of nalbuphine intravenously. The incidence of cough reflex, hemodynamic and stress marker changes, pain levels, and adverse reactions were compared between the two groups.【Results】The incidence of cough reflex was lower in the observation group than in the control group (P<0.05). There was no significant difference in the duration of cough reflex between the two groups (P>0.05). At 2 minutes after sufentanil injection (T₂), the mean arterial pressure (MAP) and heart rate (HR) were lower in both groups compared to 10 minutes before injection (T₀) and 1 minute after injection (T₁) (P<0.05), and they were lower at T₁ than at T₀ (P<0.05). MAP and HR at T₁ and T₂ were higher in the observation group compared to the control group (P<0.05). The numerical rating scale (NRS) pain scores at 4 hours (T₄) and 24 hours (T₅) postoperatively were lower than at T₃ in both groups (P<0.05), and the scores at T₅ were lower than at T₄ (P<0.05); however, there was no significant difference in NRS scores between the two groups at any time point (P>0.05). At 24 hours postoperatively, adrenaline and norepinephrine levels were elevated compared to preoperative levels in both groups (P<0.05), but there was no significant difference between the groups (P>0.05). The overall incidence of adverse reactions was not significantly different between the two groups (P>0.05).【Conclusion】Nalbuphine effectively suppresses sufentanil-induced cough reflex during anesthesia induction for LC, with minimal impact on hemodynamics. It alleviates postoperative pain and is safe and reliable.

Key words： Cholecystectomy, Laparoscopic Nalbuphine Sufentanil Anesthesia

收稿日期: 2024-10-12

中图分类号:

R657.4

引用本文:

宋佩. 纳布啡辅助抑制腹腔镜胆囊切除术麻醉诱导时舒芬太尼诱发呛咳反应的效果[J]. 医学临床研究, 2025, 42(2): 214-217.
SONG Pei. The Effect of Nalbuphine in Assisting the Suppression of Sufentanil-Induced Cough Reflex during Anesthesia Induction for Laparoscopic Cholecystectomy. JOURNAL OF CLINICAL RESEARCH, 2025, 42(2): 214-217.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.02.011 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I2/214

[1] DI BUONO G, ROMANO G, GALIA M, et al. Difficult laparoscopic cholecystectomy and preoperative predictive factors[J].Sci Rep,2021,11(1):2559.
[2] PHUVACHOTEROJANAPHOKIN N. Low-dose lidocaine attenuates fentanyl-induced cough: A double-blind randomized controlled trial[J].Eur J Clin Pharmacol,2022,78(5):813-821.
[3] DEHGHANPISHEH L, EGHBAL M, BAGHERI B F, et al.Comparison of lidocaine, huffing maneuver and combination of both in prevention fentanyl induced cough before induction of anesthesia: a double-blind, prospective, randomized placebo-controlled study[J].BMC Anesthesiol,2021,21(1):92.
[4] YU H, TIAN W, XU Z, et al. Patient-controlled intravenous analgesia with opioids after thoracoscopic lung surgery: a randomized clinical trial[J].BMC Anesthesiol,2022,22(1):253.
[5] YAN T, LIANG X Q, WANG G J, et al. Prophylactic penehyclidine inhalation for prevention of postoperative pulmonary complications in high-risk patients: a double-blind randomized Trial[J].Anesthesiology,2022,136(4):551-566.
[6] 李珍,李爱媛. 盐酸戊乙奎醚联合深呼吸法抑制麻醉诱导时芬太尼诱发咳嗽反应的有效性和安全性[J].中国现代医学杂志,2017,27(18):74-78.
[7] 别小敏,张力,陈治军. 盐酸纳布啡用于无痛纤维支气管镜对呛咳反应及相关指标的影响[J].中国内镜杂志,2021,27(11):49-54.
[8] 郝玉娟,胡胜红,王胜斌,等. 低剂量艾司氯胺酮对甲状腺切除术后苏醒期气管导管呛咳反应的影响[J].实用医学杂志,2021,37(21):2791-2794.
[9] SHAFSHAK T S, ELNEMR R. The visual analogue scale versus numerical rating scale in measuring pain severity and predicting disability in low back pain[J].J Clin Rheumatol,2021,27(7):282-285.
[10] MRAOVIC B, SIMURINA T. Effects of an intravenous lidocaine bolus before tracheal extubation on recovery after breast surgery - Lidocaine at the End (LATE) study: a randomized controlled clinical trial[J].Croat Med J,2023,64(4):222-230.
[11] 黄志菲,曹君利,王桂龙,等. 纳洛酮预防舒芬太尼诱发呛咳后术后恶心呕吐的研究[J].湖南师范大学学报(医学版),2021,18(6):151-154.
[12] WANG L L, GUAN Z Y, WANG C M, et al. A comparative study on the efficacy and safety of propofol combined with different doses of alfentanil in gastroscopy: a randomized controlled trial[J].J Anesth,2023,37(2):201-209.
[13] JU Q J, XIAO Z B, SUN W C, et al. The anesthesia induction effect of dexmedetomidine in patients undergoing laryngeal mask intubation: a systematic review and meta-analysis of 7 RCTs[J].Ann Palliat Med,2021,10(12):12358-12366.
[14] 别小敏,张力,陈治军. 盐酸纳布啡用于无痛纤维支气管镜对呛咳反应及相关指标的影响[J].中国内镜杂志,2021,27(11):49-54.
[15] 韩庆. 纳布啡预处理对急性结石性胆囊炎腹腔镜下切除术中血流动力学、应激反应及术后疼痛的影响[J].海军医学杂志,2023,44(2):173-177.