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1、布托啡諾與芬太尼用于短時手術(shù)全身麻醉的臨床比較研究【摘要】比較布托啡諾與芬太尼用于短時手術(shù)全麻中的臨床效果及不良反應(yīng)，評價布托啡諾用于全麻的臨床作用及安全性。方法ASAⅠ～Ⅱ級耳鼻咽喉科擇期聲帶息肉摘除術(shù)住院患者40例，手術(shù)時間（12±2）min，隨機(jī)分為布托啡諾組（B組，n=20）和芬太尼組(F組,n=20)。B組誘導(dǎo)靜脈注射布托啡諾20μg·kg-1，F(xiàn)組誘導(dǎo)靜脈注射芬太尼5μg·kg-1，2組4min后均靜脈注射丙泊酚及琥珀膽堿行氣管插管控制呼吸，術(shù)中靜脈輸注丙泊酚、瑞芬太尼及琥珀膽堿維持麻醉。術(shù)中監(jiān)測平均動脈壓（MAP）、心率（HR）、脈搏血氧
2、飽和度（SpO2）、呼吸頻率（RR）、術(shù)后Ramsay鎮(zhèn)靜評分及VAS鎮(zhèn)痛評分、不良反應(yīng)和拔管時間。結(jié)果①與術(shù)前相比，B組靜脈注射布托啡諾后及術(shù)后RR、SpO2無明顯變化(P>0.05)；F組靜脈注射芬太尼后及術(shù)后RR下降顯著(P<0.05)，術(shù)后拔管時間明顯大于B組(P<0.05)。②B組各時間點MAP、HR變化不明顯(P>0.05)；F組靜脈注射芬太尼后HR下降顯著(P<0.05)。③拔管后B組VAS評分明顯低于F組(P<0.05)。④F組嗆咳、惡心、肌肉僵直、寒顫、呼吸抑制等不良反應(yīng)發(fā)生率明顯高于B組(P<
3、;0.05)。結(jié)論靜脈注射20μg·kg-1布托啡諾可安全用于短時手術(shù)全身麻醉，不良反應(yīng)發(fā)生率低?！娟P(guān)鍵詞】布托啡諾全身麻醉短時手術(shù)芬太尼Abstact:ObjectiveToevaluatetheclinicaleffectand7safetyofbutorphanolinducedgeneralanesthesiainshort-timeoperationagainstthefentanylinducedone.MethodsFortypatients,withASAgradesⅠandⅡ,diagnosedtohavepolypofvocalco
4、rdforextirpation,wererandomlydividedinto2groupsof20each:butorphanolgroup(groupB)andfentanylgroup(groupF).Anesthesiawasinducedwithbutorphanol(20μg·kg-1)ingroupBandwithfentanyl(5μg·kg-1)ingroupF.Fourminlater,intravenouspropofol(2mg·kg-1)andanectine(1.5mg·kg-1)weregiventointubateth
5、etracheaandstartmechanicalventilation.Theanesthesiawasthenmaintainedwithintravenouspropofol,remifentanilandanectineduringtheoperation.Theheartrate(HR),meanarterialbloodpressure(MAP),respiratoryrate(RR),saturationofpulseoxygen(SpO2)andadverseeffectswerenoticedbeforeandduringtheop
6、erationandaftertheextubation.Thequalityofanalgesiaandsedationwasscoredafterextubation,withthetimeofextubationputdown.ResultsTherewerenosignificantchangesinRRandSpO2ingroupBaftertheintravenousbutorphanolandtheoperation(P>0.05).ButtheRRdroppedsignificantlyingroupFafterintraveno
7、usfentanylandtheoperation(P<0.05),sothetimeofextubationhadtobepostponed.TheMAPandHRwerenotalteredingroupB,buttheHRdroppedmarkedlyingroupF(P<0.05).7TheVASvalueafterextubationwassignificantlyloweringroupBthaningroupF(P<0.05).Theadversegagging,bucking,shiveringandrespirato
8、rydepressionweresignificantlylessmarkedingroupB
