下腹部手术麻醉中不同靶浓度瑞芬太尼与异丙酚的作用研究

发布时间：2019-04-02 02:03

【摘要】：目的研究下腹部手术麻醉患者应用不同靶浓度瑞芬太尼和异丙酚的作用效果。方法将我院收治的下腹部手术麻醉患者为研究对象,并按随机分组法分为3组,均固定瑞芬太尼靶浓度,A组为6ng/ml,B组为8ng/ml,C组为10ng/ml,同时改变异丙酚靶浓度,范围为2~4μg/ml,观察比较各组的麻醉效果。结果 T1时刻A组的收缩压(SBR)高于B组,心率(HR)高于C组,差异有统计学意义(P0.05);而T2、T3时刻比较,A组的SBR以及HR均较B、C组高(P0.05)。随时间推移,去甲肾上腺素(NE)各时点比较,T1时刻A组的NE高于C组,而血清皮质醇(COR)低于B、C组;T2、T3时刻A组的NE均显著高于B、C组,但3组COR变化无显著差异性(P0.05)。C组自主呼吸恢复时间、拔除气管导管时间、指令反应时间和离室时间均较长,而其睁眼时间较短(P0.05)。结论将瑞芬太尼靶浓度调节为8ng/ml,可取得较为明显的麻醉镇痛效果。
[Abstract]:Objective to study the effect of different target concentrations of remifentanil and propofol on lower abdominal anesthesia. Methods the patients undergoing lower abdominal surgery anesthesia in our hospital were divided into three groups randomly. The target concentration of remifentanil was fixed in group A, group B and group C were 6 ng / ml, 8 ng / ml and 10 ng / ml, respectively, and the concentration of remifentanil was 6 ng / ml in group A, 8 ng / ml in group B and 10 ng / ml in group C, respectively. At the same time, the target concentration of propofol was changed from 2 渭 g / ml, to 4 渭 g / mol to observe and compare the anesthetic effect of each group. Results systolic blood pressure (SBR) and heart rate (HR) in group A were higher than those in group B at T1 (P0.05), while SBR and HR in group A were higher than those in group B and group C (P0.05). The NE in group A was higher than that in group C and the serum cortisol (COR) in group A was lower than that in group B and C at T1 time. The (NE) of norepinephrine at each time point was higher in group A than in group C. At T _ 2 and T _ 3, NE in group A was significantly higher than that in group B and C, but there was no significant difference in COR among the three groups (P0.05). C group: recovery time of autonomic respiration, time of tracheal tube extubation, time of command reaction and time to leave the room). And its eye opening time is shorter (P0.05). Conclusion by adjusting the target concentration of remifentanil to 8 ng / ml, the analgesic effect can be achieved obviously.
【作者单位】：广西隆安县人民医院麻醉科;
【分类号】：R614

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