摘要： 目的 探讨纳布啡用于预防全身麻醉下悬雍垂-软腭-咽成形术患者苏醒期躁动的效果及不良反应。方法 选择行悬雍垂-软腭-咽成形术患者120例，随机分为纳布啡组（N组）和常规组（D组），2组分别采用纳布啡0.2 mg/kg（N组）和舒芬太尼0.2 μg/kg（D组）进行麻醉诱导。记录2组插管时血流动力学变化、苏醒期躁动的发生情况、拔管时间、术后不良反应以及术后第1晚睡眠质量。结果 N组苏醒期躁动发生率明显低于D组（P < 0.05），且重度苏醒期躁动人数明显减少（P < 0.05）。2组在插管即刻、插管后3 min、5 min心率以及有创平均动脉压与基线变化百分率方面无统计学差异（P > 0.05）。N组术后恶心、呕吐发生率明显降低（P < 0.05）。2组拔管时间无统计学差异（P > 0.05），且术后均未出现眩晕及呼吸抑制现象。N组术后第1晚睡眠质量优于D组（P < 0.05）。结论 应用纳布啡进行全身麻醉诱导可以安全有效地预防悬雍垂-软腭-咽成形术患者苏醒期躁动的发生，且无明显不良反应，有助于患者平稳度过围术期。

纳布啡预防全身麻醉下悬雍垂-软腭-咽成形术患者苏醒期躁动的效果

高山, 董有静

中国医科大学附属盛京医院麻醉科, 沈阳 110004

收稿日期:2021-12-14出版日期:2022-09-30发布日期:2022-09-03
通讯作者:董有静E-mail:dyj1cn@163.com
作者简介:高山（1994-），女，医师，硕士.
基金资助:辽宁省自然科学基金（MSZR202119）


关键词: 悬雍垂-软腭-咽成形术, 苏醒期躁动, 纳布啡
Abstract: Objective To evaluate the efficacy and adverse reactions of nalbuphine in the prevention of emergence agitation in patients undergoing modified uvulopalatopharyngoplasty. Methods A total of 120 patients scheduled for modified uvulopalatopharyngoplasty under general anesthesia were double-blindly and randomly divided into one of two groups(n=60 in each group):a general group(group D) and a nalbuphine group(group N). Anesthesia was induced using 0.2 mg/kg of nalbuphine in group N and 0.2 μg/kg of sufentanil in group D. The following information were recorded:hemodynamic changes during intubation, development and intensity of emergence agitation after anesthesia, extubation time, incidence of adverse drug reactions postoperatively, and the quality(degree of satisfaction) of sleep during the first postoperative night. Results The incidence of emergence agitation in group N was significantly lower than that in group D(P < 0.05), and the number of patients with severe emergence agitation was significantly lower(P < 0.05). There were no statistically significant differences in the extubation time and in the changes in heart rates and mean arterial pressure during intubation, at 3 min and at 5 min following intubation(P > 0.05). The incidences of postoperative nausea and vomiting were significantly lower in group N(P < 0.05). There was no vertigo nor postoperative respiratory depression in both groups. The quality of sleep during the first night after the operation was significantly more satisfactory in group N(P < 0.05). Conclusion Nalbuphine can safely(without any adverse reactions) and effectively prevent emergence agitation in patients undergoing modified uvulopalatopharyngoplasty.
Key words: uvulopalatopharyngoplasty, emergence agitation, nalbuphine
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