【摘要】：目的觀察納美芬對新生兒腹腔鏡幽門環(huán)切術(shù)后蘇醒的臨床效果。方法擇期氣管插管吸入麻醉下腹腔鏡幽門環(huán)切術(shù)新生兒60例,年齡15~28 d,美國麻醉醫(yī)師協(xié)會(ASA)Ⅱ~Ⅲ級,隨機分為納美芬組(M組)和納洛酮組(L組),每組30例。手術(shù)結(jié)束時M組靜脈注射納美芬0.25μg/kg,L組靜脈注射納洛酮1.00μg/kg。并記錄靜脈注射納美芬或納洛酮前(T_0)、給藥后10 min(T_1)、拔管后30 min(T_2)和拔管后2 h(T_3)的脈搏血氧飽和度(SpO_2)、平均動脈壓(MAP)、心率(HR)和呼吸頻率(RR);記錄自主呼吸恢復(fù)時間、拔管時間、麻醉后監(jiān)測治療室(PACU)停留時間及手術(shù)結(jié)束后24 h內(nèi)不良反應(yīng)(如呼吸抑制、惡心嘔吐、嗜睡和躁動等)。結(jié)果兩組在T_0、T_1、T_2和T_3時點,SpO_2、MAP和HR比較均差異無統(tǒng)計學(xué)意義(P0.05),兩組患兒T_1、T_2和T_3時的RR,均較T_0時明顯升高(P0.05),且T_1時,M組RR明顯快于L組(P0.05)。M組患兒自主呼吸恢復(fù)時間、拔管時間和PACU停留時間差均明顯短于L組(P0.05)。術(shù)后不良反應(yīng)差異無統(tǒng)計學(xué)意義。結(jié)論納美芬在合理劑量范圍內(nèi),有助于新生兒腹腔鏡幽門環(huán)切術(shù)后早期蘇醒。和納絡(luò)酮相比,可有效縮短拔管時間,促進早期恢復(fù)。
[Abstract]:Objective to observe the clinical effect of namefen on the recovery of neonates after laparoscopic pylorectomy. Methods 60 neonates with laparoscopic pylorectomy under tracheal intubation anesthesia, aged 1528 days, were randomly divided into two groups (group M, n = 30) and naloxone group (n = 30, n = 30). At the end of operation, naloxone was injected intravenously in group M with naloxone at a dose of 0.25 渭 g / kg 路kg ~ (-1) 路kg ~ (-1). The pulse oxygen saturation (SpO_2) at 10 min (T _ 1), 30 min (T _ 2) and 2 h after extubation (T _ 3), mean arterial pressure (MAP), heart rate (HR) and respiratory rate (RR);) were recorded before intravenous injection of naloxone or naloxone (T0), 10 min after administration (T _ 1), 30 min (T _ 2) after extubation and 2 h (T _ 3) after extubation. The duration of (PACU) stay in the treatment room and adverse reactions (such as respiratory depression, nausea and vomiting, lethargy and restlessness) were monitored after anesthesia. Results there was no significant difference in SPO2MAP and HR between the two groups at the time point of T0 / T _ (1) and T _ (3) (P0.05). The RRs at T _ (1) and T _ (2) and T _ (3) in two groups were significantly higher than those at T _ (0) (P0.05), and the RR of group M was significantly faster than that of group L (P 0.05) .The time of recovery of spontaneous respiration in group T _ (1) and T _ (3) was significantly higher than that in group T _ (1) and T _ (3) (P < 0.05). The difference between extubation time and PACU stay time was significantly shorter than that in L group (P0.05). There was no significant difference in postoperative adverse reactions. Conclusion nalmefen is helpful to early recovery of neonates after laparoscopic pylorectomy within a reasonable dose range. Compared with naloxone, it can shorten extubation time and promote early recovery.
【作者單位】： 南京醫(yī)科大學(xué)附屬兒童醫(yī)院麻醉科;
【分類號】：R726.1

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