不同靶浓度瑞芬太尼复合异丙酚靶控输注用于腹腔镜手术的效果及对血流动力学的影响

发布时间：2018-01-15 20:23

本文关键词：不同靶浓度瑞芬太尼复合异丙酚靶控输注用于腹腔镜手术的效果及对血流动力学的影响　出处：《山东医药》2015年01期 　论文类型：期刊论文

【摘要】：目的研究不同靶浓度瑞芬太尼符合异丙酚靶控输注用于腹腔镜手术的临床效果及对患者血流动力学的影响。方法将90例腹腔镜手术患者随机分成R4组、R6组和R8组各30例,在麻醉维持中分别维持瑞芬太尼血浆靶浓度在4.0、6.0和8.0μg/L,异丙酚血浆靶浓度均为3.0μg/L,观察各组麻醉前(T0)、切皮即刻(T1)、气腹后即刻(T2)、气腹后30 min(T3)、气腹后1 h(T4)和气腹结束时(T5)血流动力学指标变化。结果三组意识消失时间、麻醉时间、自主呼吸恢复时间、睁眼时间和拔出气管插管时间比较均无统计学差异(P均0.05)。三组T1~5时脑电双频指数(BIS)均较T0显著降低(P0.05)。R8组T1~3时BIS、T1~5时心率(HR)、T1~5时平均动脉压(MAP)均显著低于R4和R6组(P0.05)。R6组T3~5时BIS、T1~5时HR、T1~5时MAP均显著低于R4组(P0.05)。三组各时点心输出量、中心静脉压比较无统计学差异(P0.05)。结论在腹腔镜手术中,瑞芬太尼8.0μg/L复合异丙酚麻醉较4.0μg/L和6.0μg/L能够显著抑制手术刺激引起的BIS,且能维持术中稳定的血流动力学,获得满意的麻醉效果。
[Abstract]:Objective to study the clinical effect of remifentanil with different target concentration in combination with propofol target-controlled infusion for laparoscopic surgery and its effect on hemodynamics. Methods 90 patients undergoing laparoscopic surgery were randomly divided into four groups. The target concentration of remifentanil and propofol were maintained at 4.0 渭 g / L and 8.0 渭 g / L, respectively, and the plasma target concentration of propofol was 3.0 渭 g / L. The rats in each group were treated with T0, T1, T2, and T3 after pneumoperitoneum 30 min after pneumoperitoneum. Results the time of consciousness disappearance, anaesthesia time and spontaneous respiration recovery time of the three groups were changed at 1 hour after pneumoperitoneum and at the end of pneumoperitoneum. There was no significant difference in eye opening time and tracheal intubation time between the three groups (P < 0.05). The BISs of T1-#time0# EEG in the three groups were significantly lower than those in T0 group (P 0.05). Group R8: T1-#time0# BIS. The mean arterial pressure (MAPP) of T _ 1 ~ 5:00 HRT _ (1 ~ 5:00) was significantly lower than that of R4 and R6 groups (P _ (0.05)) and R _ (6) group (T _ (3 ~ 5:00) BIST _ (1 ~ 5:00) HR). The MAP of T1-#time0# was significantly lower than that of R4 group (P 0.05). There was no significant difference in the output of dim sum and the central venous pressure between the three groups. Conclusion in laparoscopic surgery, there is no significant difference (P 0.05). Remifentanil 8.0 渭 g / L combined with propofol anesthesia could significantly inhibit the BISs induced by surgical stimulation and maintain stable hemodynamics compared with 4.0 渭 g / L and 6.0 渭 g / L of remifentanil. Satisfactory anesthetic effect was obtained.
【作者单位】：东平县人民医院;
【分类号】：R614
【正文快照】： 与传统开腹手术相比,腹腔镜手术具有创伤小、术后恢复快、瘢痕小等优点[1],但同时也给术中麻醉提出了更高的要求,如在人工气腹过程中如何维持循患者血流动力学稳定和麻醉效果等[2]。瑞芬太尼是μ阿片受体激动药物,与异丙酚复合是目前腹腔镜手术常用的麻醉方法[3,4]。目前关于

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