丙泊酚闭环靶控输注系统在小儿耳鼻喉手术中的应用

发布时间：2019-03-06 18:13

【摘要】：目的评估小儿耳鼻喉手术中脑电双频指数(BIS)指导下丙泊酚复合瑞芬太尼全凭静脉闭环与开环的效果。方法选择择期行小儿扁桃体腺样体切除小儿患者40例,随机分为闭环组(T组)和开环组(C组),每组20例。2组患者均采用静脉诱导方式,诱导后T组采用系统自动调节血浆靶控浓度方式,C组采用根据术中BIS值人工调节血浆靶控浓度方式。分别于麻醉前(T0)、插管即刻(T1)、插管后5 min(T2)、10 min(T3)、15 min(T4)、30 min(T5)、拔除气管插管(T6)各时间点记录无创血压、心率、脉搏血氧饱和度、心电图、BIS、人工调节丙泊酚靶控浓度的次数、苏醒时间。结果 T组患者丙泊酚应用总量小于C组患者,总体用量降低约9.83%;2组患者瑞芬太尼用量无统计学差异;BIS值波动及术中血流动力学方面,T组患者较C组稳定。结论小儿耳鼻喉手术中丙泊酚—瑞芬太尼闭环麻醉安全易行,可调控性强,应广泛使用。
[Abstract]:Objective to evaluate the efficacy of propofol combined with remifentanil under the guidance of bispectral index (BIS) in pediatric otorhinolaryngectomy with closed-loop and open-loop remifentanil. Methods 40 children with adenoidectomy were randomly divided into two groups: closed loop group (T group) and open loop group (C group), 20 cases in each group were treated with intravenous induction, the patients in both groups were divided into two groups: group T (n = 20), group C (n = 20) and group C (n = 20). After induction, the target-controlled plasma concentration was automatically regulated by the system in group T, and the target-controlled plasma concentration was manually regulated by BIS value in group C after induction. Non-invasive blood pressure, heart rate and pulse oxygen saturation were recorded before anesthesia (T0), immediately (T1), 5 min (T2), 10 min (T3), 15 min (T4), 30 min (T5) after intubation. ECG, BIS, manual regulation of propofol target-controlled concentration of the times, wake-up time. Results the total dosage of propofol in group T was lower than that in group C, and the dosage of remifentanil in group T was 9.83% lower than that in group C, but there was no significant difference in the dosage of remifentanil between the two groups, while the fluctuation of BIS value and hemodynamics during operation in group T were more stable than those in group C. Conclusion propofol-remifentanil closed-loop anesthesia in pediatric ear, nose and throat surgery is safe, easy to control, and should be widely used.
【作者单位】：中国医科大学附属盛京医院麻醉科;
【基金】：国家自然科学基金(81401231)
【分类号】：R726.1

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