右美托咪啶对瑞芬太尼抑制下腹部手术患者切皮时体动反应半数有效效应室靶浓度的影响

发布时间：2018-03-04 19:06

本文选题：右美托咪啶　切入点：瑞芬太尼　出处：《青岛大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:评价右美托咪啶对瑞芬太尼抑制下腹部手术患者体动反应的半数有效效应室靶浓度(EC50)的影响.方法:择期行子宫全切术或子宫肌瘤剜除术患者,ASA分级I或II级,年龄20-60岁,体重指数20-30kg/m2,采用随机数字表法,将患者随机分为2组,D组静脉输注右美托咪啶0.6μg/kg,时间设定为10min,C组给予生理盐水,停药5min时开始靶控输注异丙酚,血浆靶浓度3.0μg/ml,输注12min时,2组开始靶控输注瑞芬太尼,第1例的效应室靶浓度为4.5ng/ml,输注瑞芬太尼3min时置入喉罩,保留自主呼吸,待瑞芬太尼达到目标靶浓度后开始手术。根据切皮时是否发生体动反应确定下一例患者瑞芬太尼的靶浓度,相邻靶浓度比值为1.2.采用序贯法计算瑞芬太尼抑制切皮时体动反应的EC50及其95%可信区间(95%CI)。结果:D组和C组样本数分别为18和20.瑞芬太尼抑制切皮时体动反应的EC50分别为1.23 ng/ml(95%CI 1.16-1.30 ng/ml)和1.52 ng/ml(95%CI 1.44-1.60 ng/ml),D组比C组降低19%(P0.05。结论:术前静脉注射右美托咪啶0.6μg/kg可降低瑞芬太尼抑制下腹部手术患者切皮时体动反应的EC50,大约降低19%。
[Abstract]:Objective: to evaluate the effect of dexmetidine on the inhibitory effect of remifentanil on body motility in patients undergoing lower abdominal surgery. Methods: selective hysterectomy or enucleation of uterine myoma was performed in patients with ASA grade I or II. Age 20-60 years, body mass index (BMI) 20-30kg / m2. Patients were randomly divided into two groups: group D: dexmetidine 0.6 渭 g / kg, group C was given normal saline for 10 min, and propofol was administered by target control at 5 min after withdrawal. The plasma target concentration was 3.0 渭 g / ml. The target controlled remifentanil was given to the two groups at 12 min after infusion. The target concentration of the first group was 4.5 ng / ml. Remifentanil was implanted into the laryngeal mask at 3 min to retain spontaneous respiration. Surgery begins when remifentanil reaches its target concentration. The target concentration of remifentanil in the next patient is determined on the basis of whether the volume response occurs during the skin incision. The ratio of adjacent target concentration was 1.2. The EC50 and its 95% confidence interval of remifentanil on the inhibition of body motility during skin incision were calculated by sequential method. Results the samples of group D and group C were 18 and 20 respectively. The EC50 of remifentanil inhibited the somatic response during skin incision. 1.23 ng/ml(95%CI 1.16-1.30 ng / ml) and 1.52 ng/ml(95%CI 1.44-1.60 ng / ml group D decreased 19g / ml compared with C group (P 0.05). Conclusion: preoperative intravenous injection of dexmetidine 0.6 渭 g / kg can reduce EC50 of remifentanil inhibition in patients undergoing lower abdominal surgery, and decrease by 19.5%.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R614

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