舒芬太尼复合丙泊酚对开腹胆囊术应激反应及最佳剂量研究

发布时间：2018-04-05 19:26

本文选题：舒芬太尼　切入点：丙泊酚　出处：《临床医药文献电子杂志》2016年53期

【摘要】：目的探究舒芬太尼复合丙泊酚对开腹胆囊术应激反应以及对疾病治疗的最佳使用剂量。方法选取2008年1月~2016年9月某医院收治的腹腔镜胆囊切除术患者100例作为研究对象,根据患者选择的舒芬太尼麻醉剂的剂量进行随机分组,并将每组按照一、二、三、四的序号进行命名,各25例。麻醉诱导:对每组患者分别注射咪达唑仑0.03 mg/kg,然后再通过把控输注的方式进行丙泊酚药物的注射。当患者的血液中丙泊酚的浓度达到2.0μg/m L时,在通过静脉注射的方式注射舒芬太尼0.5、0.6、0.7、0.8μg/kg,然后再对每组患者注射维库溴铵0.1 mg/kg,在2 min后进行气管插管操作。对患者在进行麻醉之前(T0)、患者血浆中丙泊酚浓度达到2.0μg/m L时(T1)、静脉注射舒芬太尼之后(T2)、对患者进行气管插管操作之前(T3)、气管插管操作完成之后(T4)、1 min(T5)、3 min(T6)、5 min(T7)的HR、SP、DP、MAP的情况进行检测和记录,并且对发生的不良事件进行情况记录。结果第一、二、三、四组的丙泊酚的EC50及95%可信区间分别是2.04(1.97~2.22)、1.94(1.87~2.12)、1.54(1.57~1.86)、1.44(1.37~1.82)μg/m L,相对于第一、二组来说,第三、四组的丙泊酚EC50值有降低。在T1~4测量的所有时间点,第三、四组发生低血压的几率要比第一、二组的高。在T5~7时间内,第三、四组发生心动过缓的几率要比第一、二组的高。在T4时刻四组患者的高血压和心动过速的症状均没有明显区别。结论舒芬太尼复0.6μg/kg符合丙泊酚2.0μg/m L时对开腹胆囊术应激反应最小,所以临床治疗应该选择的最佳剂量。
[Abstract]:Objective to investigate the optimal dose of sufentanil combined with propofol for stress response and disease treatment in open cholecystectomy.Methods from January 2008 to September 2016, 100 patients with laparoscopic cholecystectomy in a hospital were randomly divided into three groups according to the dose of sufentanil.Four serial numbers were named, 25 cases each.Anesthesia induction: midazolam 0.03 mg / kg was injected into each group and then propofol was injected by controlled infusion.When the concentration of propofol in blood reached 2.0 渭 g / mL, sufentanil was injected by intravenous injection of sufentanil (0.5 渭 g / ml), and then vecuronium (0.1 mg / kg) was injected into each group, and endotracheal intubation was performed at 2 min after intravenous injection of vecuronium (0.1 mg / kg).The condition is detected and recorded,And the adverse events occurred to record the situation.The third and fourth groups were more likely to develop hypotension than those in the first and second groups at all time points in the T _ 1 / T _ 4 measurements.The third and fourth groups were more likely to develop bradycardia than those in the first and second groups.There was no significant difference in the symptoms of hypertension and tachycardia between the four groups at T 4.Conclusion when sufentanil 0.6 渭 g/kg is in accordance with propofol 2.0 渭 g / mL, the stress response to open cholecystectomy is the least, so the optimal dose should be chosen for clinical treatment.
【作者单位】：康保县人民医院手术室;张家口市第六医院药剂科;张家口市宣化区医院麻醉科;张家口市万全区中医院外科;阳原县人民医院外科;
【分类号】：R614

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