丙泊酚联合依托咪酯麻醉诱导对顺苯磺酸阿曲库铵起效时间及气管插管条件的影响

发布时间：2018-01-20 14:30

本文关键词： 药物效应顺苯磺酸阿曲库铵丙泊酚依托咪酯全身麻醉　出处：《山东医药》2016年23期 　论文类型：期刊论文

【摘要】：目的观察丙泊酚联合依托咪酯全身麻醉诱导对顺苯磺酸阿曲库铵药效学及气管插管条件的影响。方法择期拟行全身麻醉外科手术患者60例,将其随机分为丙泊酚诱导组(P组)、依托咪酯诱导组(E组)和丙泊酚联合依托咪酯诱导组(PE组)各20例。入室后均在左上肢肘部建立静脉通道,静脉予咪达唑仑0.05 mg/kg,靶控输注瑞芬太尼(效应室靶浓度3 ng/m L),P组靶控输注丙泊酚(血浆靶控浓度为3μg/m L),E组靶控输注依托咪酯(血浆靶控浓度为0.6μg/m L),PE组同时输注丙泊酚(血浆靶控浓度为1.5μg/m L)和依托咪酯(血浆靶控浓度为0.3μg/m L)。3组均静注顺苯磺酸阿曲库铵1.5 mg/kg,于5 s内注射完毕,气管插管。记录诱导前(T0)、气管插管前即刻(T1)、插管后即刻(T2)、插管后1 min(T3)、插管后3 min(T4)患者的SBP、DBP、MAP、心率和BIS;记录气管插管条件Cooper's评分,肌松效应起效时间;记录所有患者术后1、24、48、72 h时咽喉痛、咳嗽、咳痰的发生率。结果P组气管插管条件Cooper's评分优13例、良5例、中2例、差0例,E组分别为16、4、0、0例,PE组分别为15、4、1、0例,3组比较,P0.05。P组、E组、PE组顺苯磺酸阿曲库铵起效时间分别为(191.10±18.44)、(158.10±11.57)、(170.90±16.57)s,E组、PE组与P组比较,P均0.05。3组患者术后咽喉痛、咳嗽、咳痰发生率比较差异无统计学意义。结论丙泊酚联合依托咪酯全身麻醉诱导,可以在维持血流动力学稳定的情况下,缩短顺苯磺酸阿曲库铵的起效时间,提供满意的气管插管条件。
[Abstract]:Objective to observe the effect of propofol combined with etomidate on pharmacodynamics and tracheal intubation conditions of atracurium cisbenzenesulfonate. They were randomly divided into propofol induction group (n = 20), etomidate induction group (n = 20) and propofol combined with etomidate induction group (n = 20). Midazolam 0. 05 mg / kg, target controlled infusion of remifentanil (target controlled infusion of propofol 3 ng/m 路L ~ (-1)) (plasma TCI = 3 渭 g / mL). Etomidate (plasma target control concentration 0.6 渭 g / mL) was injected into E group. In PE group, propofol (plasma target control concentration was 1.5 渭 g / mL) and etomidate (plasma target control concentration was 0.3 渭 g / mL) simultaneously. Group 3 were given intravenous injection of atracurium cisbenzenesulfonate for 1. 5 mg/kg. Endotracheal intubation was completed within 5 seconds. T0 was recorded before induction, T1 was injected immediately before tracheal intubation, T2 was injected immediately after intubation, and T3 was recorded 1 min after intubation. SBP DBP MAPP, heart rate and BIS3 min after intubation. The Cooper's score of tracheal intubation condition and the onset time of muscle relaxation were recorded. The incidence of sore throat, cough and expectoration was recorded in all the patients at 1: 24 and 48 / 72 h postoperatively. Results the Cooper's score of tracheal intubation condition in group P was excellent in 13 cases, good in 5 cases and fair in 2 cases. The difference between E group (n = 0) and PE group (n = 16) was 154D (n = 10). The difference between group E and group P 0.05.P was higher than that in group E (P 0.05.P, P = 0.05.P, P = 0.05.P, P = 0.05.P). The onset time of atracurium cis-benzenesulfonate in PE group was 191.10 卤18.44, 158.10 卤11.57 and 170.90 卤16.57 in E group, respectively. There was no significant difference in the incidence of larynx, cough and expectoration between PE group and P group (0.05.3). Conclusion propofol combined with etomidate is induced by general anesthesia. Under the condition of maintaining hemodynamic stability, the onset time of atracurium cis-benzenesulfonate can be shortened and the conditions of tracheal intubation can be satisfied.
【作者单位】：天津医科大学第二医院;
【分类号】：R614
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