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芬太尼与纳布啡用于全静脉麻醉(TIVA)的比较。

Comparison of fentanyl and nalbuphine in total intravenous anaesthesia (TIVA).

作者信息

Khan F A

机构信息

Department of Anaesthesiology, The Aga Khan University, Karachi.

出版信息

J Pak Med Assoc. 2002 Oct;52(10):459-65.

Abstract

OBJECTIVE

To compare Nalbuphine and fentanyl as total intravenous anaesthesia with propofol infusion in laproscopic cholecystectomy cases.

STUDY DESIGN

Double blind randomised.

METHODS

Changes in haemodynamic variables greater than twenty percent above or below the baseline and recovery profile were observed.

RESULTS

Blood pressure remained within 20% of baseline in either group. Nine patients in fentanyl and fifteen in nalbuphine group required an additional bolus of propofol intraoperatively. Heart rate response after tracheal intubation was significantly higher in the nalbuphine group (25%). No difference was observed in the incidence of nausea and vomiting in the recovery room. Twenty-seven percent patients in the nalbuphine group required analgesia in the recovery in comparison to 87% in the fentanyl group. Patients in the fentanyl group required analgesia earlier (37 minutes vs. 62 minutes).

CONCLUSION

Fentanyl provided better intraoperative haemodynamic stability in comparison to nalbuphine when used as the analgesic component in total intravenous anaesthesia with propofol. The recovery profile with both drugs was similar. Lesser number of patients required analgesia in the recovery in the nalbuphine group.

摘要

目的

比较纳布啡和芬太尼在腹腔镜胆囊切除术病例中作为丙泊酚输注全静脉麻醉的效果。

研究设计

双盲随机试验。

方法

观察血流动力学变量相对于基线水平上下波动超过20%的变化情况以及恢复情况。

结果

两组患者血压均维持在基线水平的20%以内。芬太尼组有9例患者、纳布啡组有15例患者术中需要额外追加丙泊酚推注。纳布啡组气管插管后的心率反应显著更高(25%)。恢复室中恶心呕吐的发生率无差异。纳布啡组27%的患者在恢复过程中需要镇痛,而芬太尼组为87%。芬太尼组患者更早需要镇痛(37分钟对62分钟)。

结论

在丙泊酚全静脉麻醉中作为镇痛成分使用时,芬太尼比纳布啡能提供更好的术中血流动力学稳定性。两种药物的恢复情况相似。纳布啡组在恢复过程中需要镇痛的患者数量较少。

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