摘要
目的:观察靶控输注瑞芬太尼复合丙泊酚静脉麻醉对中老年颅内动脉瘤夹闭术患者血流动力学的影响。方法:行颅内动脉瘤夹闭术的中老年患者40例随机分为复合组和丙泊酚组。复合组行瑞芬太尼复合丙泊酚靶控静脉麻醉,丙泊酚组采用丙泊酚静脉输注降压。观察两组患者麻醉诱导前(T_1)、气管插管前(T_2)、动脉瘤夹闭前(T_3)、动脉瘤夹闭后(T_4)、拔除气管时(T_5)等时间点的平均动脉压(MAP)、心率(HR)、心排血量(CO)和心指数(CI);比较两组患者麻醉维持时间、拔管时间、术后唤醒时间和术后不良反应情况。结果:两组患者各时间点MAP、HR差异均无统计学意义(P>0.05),复合组T_2、T_3、T_4时MAP、HR、CO和CI均显著低于T_1时,且CO和CI均显著低于丙泊酚组同时点。术后复合组拔管时间、唤醒时间和不良反应发生率均显著低于丙泊酚组(P<0.05)。结论:TCI瑞芬太尼复合丙泊酚有助于颅内动脉瘤夹闭术患者保持血流动力学稳定,缩短拔管时间和唤醒时间,减少不良反应发生。
Objective： To observe the effect of intravenous anesthesia with target-controlled infusion （TCI） of remifentanil combined with propofol on hemodynamics in middle-aged and elderly patients with intracranial aneurysm clipping. Methods： Totally 40 cases of middle-aged and elderly patients undergoing intracranial aneurysm clipping were divided into combined anesthesia group and propofol group according to the random number table. The combined anesthesia group was treated With remifentanil combined with propofol target intravenous anesthesia, and propofol group was treated with propofol intravenous hypotension. The changes of mean arterial pressure（ MAP）, heart rate（ HR）, cardiac output（CO） and heart index（CI） before the induction of anesthesia （ T1 ） , tracheal intubation （ T2 ）, before aneurysm clipping（ T3 ） , after aneurysm clipping（ T4 ） and extubation （T5） were observed. The anesthesia maintenance time, extubation time, postoperative wake-up time and adverse reactions were compared. Results： There were no significant differences in MAP and HR between the groups（P 〉 0.05）, the levels of MAP, HR, CO and CI at T2, T3 and T4 were significantly lower than those at T1 , and CO and CI were significantly lower in combined group than those in propofol group （ P 〈 0.05 ）. Conclusion： TCI remifentanil combined with propofol can maintain hemodynamic stability, shorten extuhation time and wake-up time, and reduce the incidence of adverse reactions in the patients with intracranial aneurysm clipping.
作者
谷志杰
赵素敏
王飞
王俊宏
李清伟
Gu Zhijie;Zhao Sumin;Wang Fei;Wang Junhong;Li Qingwei(, Department of Anesthesiology, Leting County Hospital, Hebei Tangshan 063600, China;Department of Anesthesiology, Caofeidian Hospital, Tangshan City)
出处
《中国药师》
CAS
2018年第5期861-863,共3页
China Pharmacist
基金
河北省医学科学研究重点课题(编号:20171387)
