参附注射液对全身麻醉苏醒的影响及作用机制

目的 :观察参附注射液对全身麻醉苏醒的影响 ,并探讨其作用机制。方法 :4 0例ASAⅠ～Ⅱ级、全身麻醉时间为 3～ 4h的择期腹部手术患者 ,手术结束后送入麻醉恢复室随机分为两组 ,每组 2 0例 :试验组 ,入室后静脉滴注参附注射液 1 0ml/kg(加入生理盐水共 10 0ml) ;对照组 ,入室后以等量生理盐水代替参附注射液静脉滴注。采用双盲原则 ,观察并记录用药后患者自主通气恢复时间、拔管时间、离室时间及格拉斯哥 (GCS)评分情况 ,并于用药前 ,用药后 5、15、30min各采外周静脉血 2ml测定各时间点血浆β 内啡肽 (β EP)的含量。结果 :试验组的自主通气恢复时间、拔管时间、离室时间均较对照组缩短 (P <0 0 1) ;试验组的GCS评分情况优于对照组 (P <0 0 1) ;血浆β EP随着患者逐渐苏醒其浓度逐渐升高 ,而试验组与对照组同期血浆β EP的含量比较 ,用药前与用药后 5min差异无显著性 (P >0 0 5 ) ,而用药后 15min、30min试验组高于对照组 (P <0 0 1) ;各组用药后 5min与用药前比较差异无显著性 (P >0 0 5 ) ,而用药后 15、30min与用药前比较差异均有显著性 (P <0 0 1)。结论 :参附注射液可加快全身麻醉后苏醒 ,其机制可能与其升高血浆 β EP的作用有关。

英文摘要:

Objective: To investigate the effect and the mechanism of Shenfu injection (SFI) on the resuscitation from general anesthesia. Methods: Forty patients who received selective abdominal surgery with general anesthesia for 3-4 hrs and ASA grade Ⅰ-Ⅱ were divided into two groups, the trial group and the control group, 20 patients in each group. After being sent into the postanesthesia care unit (PACU), the trial group was treated with intravenous dripping of SFI 1.0 ml/kg and the control group was treated with intravenous dripping of equal volume of normal saline. All patients were observed in double blindly manner, the self ventilation recovery time, extubation time, the time of leaving PACU and their Glasgow coma scale (GCS) were recorded and compared. 2 ml of peripheral venous blood were taken to determine the plasma β-endorphin (β-EP) content at the time points of before (T1), 5min (T2), 15min (T3) and 30 min (T4) after dripping. Results: The self ventilation recovery time, extubation time and time of leaving PACU in the trial group were all shorter than those in the control group (P<0 01), the GCS in the trial group was better than that in the control group (P<0 01). The plasma content of β-EP raised gradually along the recovering of patients consciousness, as compared with the content before dripping (T1), it showed insignificant difference at time point T2 but significant difference at T3 and T4 comparison at the corresponding time point showed that the content at T1 and T2 were similar in the two groups (P>0 05), but at T3 and T4, the content was higher in the trial group than that in the control group respectively (P<0 01). Conclusion: SFI could accelerate the resuscitation after general anesthesia, the mechanism may be related with its action in raising plasma β-EP level.

关闭