瑞芬太尼复合丙泊酚行腹腔镜胆囊手术麻醉的观察被引量：9

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摘要目的评价瑞芬太尼-丙泊酚全凭静脉麻醉的维持和术后苏醒过程。方法40例美国麻醉学会手术前分级标准原则(ASA)Ⅰ～Ⅱ级择期行腹腔镜胆囊切除术(LC)的病人,随机分为两组:静吸复合麻醉组(C组)和全凭静脉麻醉组(R组),每组20例。两组均以咪唑安定0.04mg/kg、芬太尼4μg/kg、丙泊酚1.5～2.0mg/?和维库溴铵0.1mg/kg诱导后气管插管。麻醉维持:C组:用2%安氟醚吸入;R组:用0.9%氯化钠注射液360ml+丙泊酚注射液400mg+瑞芬太尼1mg按75滴/min的速度静脉输注。记录病人麻醉诱导前,切皮后和术毕的平均动脉压(MAP)和心率(HR);记录术毕停药后病人苏醒时间和拔管时间。结果C组病人切皮后、术毕的MAP、HR升高的程度比R组病人明显。两组病人切皮后和术毕的MAP分别与诱导前的MAP比较差异有显著性(P<0.05)。两组病人术后苏醒时间和拔管时间比较差异有显著性(P<0.05)。结论与静吸复合麻醉下LC比较,人工输注瑞芬太尼-丙泊酚混合液全凭静脉麻醉用于LC时,麻醉维持平稳,术中血流动力学稳定,术后苏醒快,拔管早,安全可行。

作者杜良刚

机构地区武汉市第十三医院麻醉科

出处《临床和实验医学杂志》 2008年第8期129-129,132,共2页 Journal of Clinical and Experimental Medicine

关键词瑞芬太尼丙泊酚全凭静脉麻醉静吸复合麻醉

分类号 R614 [医药卫生—麻醉学]

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1耿志宇,许幸.雷米芬太尼麻醉中应注意的若干问题[J].临床麻醉学杂志,2006,22(11):883-884. 被引量：60
2刘建华,沈金美,李李,常业恬.瑞芬太尼丙泊酚全凭静脉麻醉与静吸复合麻醉用于腹腔镜胆囊切除术的比较[J].中国新药杂志,2006,15(3):222-224. 被引量：31
3耿志宇,宋琳琳,许幸,吴新民.异丙酚复合芬太尼或瑞芬太尼靶控静脉麻醉与静吸复合麻醉的比较[J].中华麻醉学杂志,2004,24(1):14-17. 被引量：317

二级参考文献25

1WIETASCH G, SCHOIZ M, Propofol clearance is decreased by remifentanil [J]. Anesthesiology, 1999, 91 (2) :433 - 435.
2PIEPHO RW. Overview of the angiotension-converting-enzyme inhibitors [J] . Am J Health Syst Pharm, 2000, 57(1):3 - 7.
3GLASS PA, GAN TJ, HOWELL S. A review of the pharmacokinetics and pharmacodynamics of remifentanil [J]. Anesth Analg,1999, 89(4Suppl) :S7 - S14.
4ROBERTS FI, DIXON J. Induction and maintenance of propofol anesthesia: a manual infusion scheme [J]. Anesthesia, 1988, 43(2Supp]) :S14 - S16.
5Fletcher D,Pinaud M,Scherpereel P,et al.The efficacy of intravenous 0.15 versus 0.25 mg/kg intraoperative morphine for immediate postoperative analgesia after remifentanil-based anesthesia for major surgery.Anesth Analg,2000,90:666-671.
6van der Zwan T,Baerts WD,Perez RS,et al.Postoperative condition after the use of remifentanil with a small dose of piritramide compared with a fentanyl-based protocol in patients undergoing craniotomy.Eur J Anaesthesiol,2005,22:438-441.
7Van Elstraete AC,Lebrun T,Sandefo I,et al.Ketamine does not decrease postoperative pain after remifentanil-based anaesthesia for tonsillectomy in adults.Acta Anaesthesiol Scand,2004,48:756-760.
8Munoz HR,Guerrero ME,Brandes V,et al.Effect of timing of morphine administration during remifentanil-based anaesthesia on early recovery from anaesthesia and postoperative pain.Br J Anaesth,2002,88:814-818.
9Cafiero T,Di Minno RM,Sivolella G,et al.Immediate postoperative pain management in patients undergoing major abdominal surgery after remifentanil-based anesthesia:sufentanil vs tramadol.Minerva Anestesiol,2004,70:661-669.
10Habib AS,Parker JL,Maguire AM,et al.Effect of remifentanil and alfentanil on the cardiovascular response to induction of anaesthesia and tracheal intubation in the elderly.Br J Anaesth,2002,88:430-433.