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目的:观察小剂量舒芬太尼复合丙帕他莫对口腔颌面外科手术患者术后苏醒期拔管时应激反应的效果。方法:选取60例ASAⅠ～Ⅱ级择期在全身麻醉下行口腔颌面外科手术的患者,随机分为舒芬太尼组(S组)、舒芬太尼复合丙帕他莫组(S+P组)和生理盐水对照组(C组),每组各20例。S组于手术结束时静脉推注舒芬太尼0.2μg/kg,S+P组于手术结束时静脉推注舒芬太尼0.1μg/kg+静脉输注20g/L丙帕他莫50mL,C组于手术结束时静脉输注生理盐水50mL。分别记录患者手术结束时(T0)、拔管后1min(T1)、3min(T2)、5min(T3)时的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR),并于以上各时点抽取动脉血测定血糖,记录清醒和拔管时间以及其他不良反应。采用SPSS12.0软件包进行统计学处理。结果:T1-T3时,S组及S+P组的MAP、HR均低于C组;T1-T3时,C组血糖高于T0时,同时也高于S组及S+P组。拔管时,C组躁动发生率显著高于S组及S+P组,S组的清醒时间较S+P组及C组显著延长。结论:口腔颌面外科手术患者拔管前给予小剂量舒芬太尼复合丙帕他莫,可以减轻苏醒期拔管时的应激反应。
OBJECTIVE: To observe the effect of sufentanil combined with propantamil on stress response during extubation in patients undergoing oral and maxillofacial surgery during the recovery period. Methods: Sixty patients with ASA Ⅰ ~ Ⅱ elective oral and maxillofacial surgery under general anesthesia were randomly divided into three groups: sufentanil group (S group), sufentanil combined with propatinamil group (S + P group) ) And saline control group (C group), 20 cases in each group. S group at the end of surgery intravenous injection of sufentanil 0.2μg / kg, S + P group at the end of the surgery intravenous sufentanil 0.1μg / kg + intravenous infusion of 20g / L propatinam 50mL, C Group at the end of surgery intravenous infusion of 50mL saline. The systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR) at the end of the operation (T0), 1min (T1), 3min (T2) and 5min HR), and in the above time points arterial blood glucose was measured, sober and extubation time and other adverse reactions. SPSS12.0 software package for statistical analysis. Results: At T1-T3, the MAP and HR of S group and S + P group were lower than those of C group. At T1-T3, the blood glucose of group C was higher than that of T0, and also higher than those of S group and S + P group. At extubation, the incidence of agitation in group C was significantly higher than those in group S and S + P, and the awake time in group S was significantly longer than that in group S + P and group C. CONCLUSIONS: Oral and maxillofacial surgery patients given low doses of sufentanil combined with propantamil prior to extubation may reduce the stress response during extubation.