摘要
目的探讨不同剂量瑞芬太尼对丙泊酚靶控输注(TCI)诱导时麻醉深度的影响。方法选取2020年8月至2021年7月深圳市宝安区中医院120例腹腔镜手术患者作为研究对象,按随机数字表法将其分为A组(30例)、B组(30例)、C组(30例)和D组(30例)。四组患者均于全麻下行腹腔镜手术治疗,A组输注氯化钠注射液,B组、C组、D组分别静脉输注0.1、0.2、0.4μg/(kg·min)瑞芬太尼。比较四组患者麻醉诱导前(T_(0))、插管前即刻(T_(1))、拔管后1 min(T_(2))时的平均动脉压(MAP)、心率(HR)水平、脑电双频指数(BIS)以及丙泊酚输注16 min后的MOAA/S评分。结果四组患者T_(1)的MAP、HR均低于本组T_(0)时,差异有统计学意义(P<0.05);A组、B组T_(2)时的MAP、HR均高于本组T_(0)时,B组、C组、D组T_(1)时的MAP、HR均低于A组,C组、D组T_(1)时的MAP、HR均低于B组,差异有统计学意义(P<0.05);C组与D组T_(0)、T_(1)、T_(2)时的MAP、HR比较,差异无统计学意义(P>0.05)。四组T_(1)、T_(2)时的BIS均低于本组T_(0)时,差异有统计学意义(P<0.05);B组、C组、D组T_(1)时的BIS均低于A组,C组、D组T_(1)时的BIS均低于B组,差异有统计学意义(P<0.05)。丙泊酚输注16 min后,A组、B组、C组、D组的改良警觉镇静(MOAA/S)评分分别为(1.97±0.76)、(1.78±0.72)、(1.34±0.55)、(1.28±0.50)分,其中C组、D组的MOAA/S评分均低于A组、B组,差异有统计学意义(P<0.05)。结论不同剂量的瑞芬太尼对丙泊酚TCI诱导时的麻醉深度影响不同,与0.1μg/(kg·min)的瑞芬太尼相比,采用0.2、0.4μg/(kg·min)的瑞芬太尼能够稳定患者血流动力学,增强镇静效果,达到有效麻醉深度。
Objective To investigate the effect of different doses of Remifentanil on the depth of anesthesia induced by target controlled infusion(TCI)of Propofol.Methods A total of 120 laparoscopic surgery patients in Baoan District Hospital of Traditional Chinese Medicine of Shenzhen City from August 2020 to July 2021 were selected as the research objects and divided into group A(30 cases),group B(30 cases),group C(30 cases)and group D(30 cases)according to random number table method.The four groups were treated by laparoscopy under general anesthesia.Sodium Chloride Injection was infused in group A,and 0.1,0.2,0.4μg/(kg·min)Remifentanil were infused intravenously in groups B,C,and D,respectively.Mean arterial pressure(MAP),heart rate(HR),bispectral index(BIS)before anesthesia induction(T_(0)),immediately before intubation(T_(1)),1 min after extubation(T_(2)),and MOAA/S scores 16 min after Propofol infusion were compared among the four groups.Results The MAP and HR of T_(1) in four groups were lower than those of T_(0),the differences were statistically significant(P<0.05).The MAP and HR of group A and group B at T_(2) were higher than those of T_(0),the MAP and HR of group B,group C and group D at T_(1) were lower than those of group A,the MAP and HR of group C and group D at T_(1) were lower than those of group B,the differences were statistically significant(P<0.05).There were no significant differences in MAP and HR between group C and group D at T_(0),T_(1) and T_(2)(P>0.05).BIS of the four groups at T_(1) and T_(2) were lower than those at T_(0),the differences were statistically significant(P<0.05).The BIS at T_(1) of group B,C and D was lower than that of group A,and the BIS at T_(1) of group C and D was lower than that of group B,with statistical significance(P<0.05).After 16 min of Propofol infusion,the MOAA/S scores in group A,B,C and D were(1.97±0.76),(1.78±0.72),(1.34±0.55)and(1.28±0.50)points,respectively.The MOAA/S scores in group C and D were lower than those in groups A and B,the differences were statistically significant(P<0.05).Conclusion Different doses of Remifentanil have different effects on the depth of anesthesia during Propofol TCI induction.Compared with 0.1μg/(kg·min)Remifentanil,0.2 and 0.4μg/(kg·min)Remifentanil can stabilize the hemodynamics of patients,enhance the sedation effect and achieve the effective depth of anesthesia.
作者
董文明
康力
时佳
刘华
吕东森
DONG Wenming;KANG Li;SHI Jia;LIU Hua;LYU Dongsen(Department of Anesthesiology,Bao'an District Hospital of Traditional Chinese Medicine,Guangdong Province,Shenzhen 518133,China;Yulongwan Health Service Center,Shenzhen Bao'an District Hospital of Traditional Chinese Medicine,Guangdong Province,Shenzhen 518133,China)
出处
《中国当代医药》
CAS
2023年第1期117-120,共4页
China Modern Medicine
基金
广东省深圳市宝安区基础研究(医疗卫生类)项目(2021JD085)。
关键词
腹腔镜手术
瑞芬太尼
丙泊酚
靶控输注
麻醉深度
Laparoscopic surgery
Remifentanil
Propofol
Target controlled infusion
Depth of anesthesia
