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在全身麻醉下进行腹腔镜胆囊切除术时,可乐定与芬太尼用于术前用药对术中血流动力学稳定性和恢复结果的影响

Premedication with clonidine versus fentanyl for intraoperative hemodynamic stability and recovery outcome during laparoscopic cholecystectomy under general anesthesia.

作者信息

Gupta Kumkum, Lakhanpal Mahima, Gupta Prashant K, Krishan Atul, Rastogi Bhawna, Tiwari Vaibhav

机构信息

Department of Anaesthesiology and Critical Care, N.S.C.B. Subharti Medical College, Swami Vivekananda Subharti University, Subhartipuram, NH-58, Meerut, Uttar Pradesh, India.

Department of Radio diagnosis, Imaging and Interventional Radiology, N.S.C.B. Subharti Medical College, Swami Vivekananda Subharti University, Subhartipuram, NH-58, Meerut, Uttar Pradesh, India.

出版信息

Anesth Essays Res. 2013 Jan-Apr;7(1):29-33. doi: 10.4103/0259-1162.113984.

Abstract

BACKGROUND

Laparoscopic cholecystectomy under general anesthesia induced intraoperative hemodynamic responses which should be attenuated by appropriate premedication. The present study was aimed to compare the clinical efficacy of clonidine and fentanyl premedication during laparoscopic cholecystectomy for attenuation of hemodynamic responses with postoperative recovery outcome.

SUBJECTS AND METHODS

In this prospective randomized double blind study 64 adult consented patients of either sex with ASA I and II, scheduled for elective laparoscopic cholecystectomy under general anesthesia and met the inclusion criteria, were allocated into two groups of 32 patients. Group C patients have received intravenous clonidine 1μg kg(-1) and Group F patients have received intravenous fentanyl 2μg kg(-1) 5 min before induction. Anesthetic and surgical techniques were standardized. All patients were assessed for intraoperative hemodynamic changes at specific time and postoperative recovery outcome.

RESULTS

Premedication with clonidine or fentanyl has attenuated the hemodynamic responses of laryngoscopy and laparoscopy. Clonidine was superior to fentanyl for intraoperative hemodynamic stability. No significant differences in the postoperative recovery outcome were observed between the groups. Nausea, vomiting, shivering and respiratory depression were comparable between groups.

CONCLUSION

Premedication with clonidine or fentanyl has effectively attenuated the intraoperative hemodynamic responses of laparoscopic cholecystectomy.

摘要

背景

全身麻醉下的腹腔镜胆囊切除术会引发术中血流动力学反应,适当的术前用药应能减轻这种反应。本研究旨在比较可乐定和芬太尼术前用药在腹腔镜胆囊切除术中减轻血流动力学反应及术后恢复情况方面的临床疗效。

对象与方法

在这项前瞻性随机双盲研究中,64例年龄≥18岁、美国麻醉医师协会(ASA)分级为Ⅰ或Ⅱ级、自愿接受全身麻醉下择期腹腔镜胆囊切除术且符合纳入标准的成年患者被随机分为两组,每组32例。C组患者在诱导前5分钟静脉注射可乐定1μg/kg,F组患者在诱导前5分钟静脉注射芬太尼2μg/kg。麻醉和手术技术标准化。所有患者均在特定时间评估术中血流动力学变化及术后恢复情况。

结果

可乐定或芬太尼术前用药均减轻了喉镜检查和腹腔镜检查时的血流动力学反应。可乐定在维持术中血流动力学稳定方面优于芬太尼。两组术后恢复情况无显著差异。两组恶心、呕吐、寒战和呼吸抑制的发生率相当。

结论

可乐定或芬太尼术前用药均能有效减轻腹腔镜胆囊切除术的术中血流动力学反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5e1/4173492/d2e880a49d5b/AER-7-29-g004.jpg

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