期刊文献+

靶控输注异丙酚复合瑞芬太尼或芬太尼全静脉麻醉 预览 被引量:100

Target- controlled infusion of propofol for TIVA with remifentanil or fentanyl
在线阅读 下载PDF
分享 导出
摘要 目的比较瑞芬太尼和芬太尼对异丙酚静脉麻醉作用的影响.方法选择110例择期手术患者,分别采用异丙酚(P组,n=30)、异丙酚芬太尼(PF组,n=52)靶控输注或者异丙酚靶控输注复合瑞芬太尼(PR组,n=28)持续输注全静脉麻醉.芬太尼靶浓度2 μg/L,瑞芬太尼麻醉诱导和维持分别为0.25~0.5及0.125~0.25μg(kg·min),异丙酚初始靶浓度为1 mg/L,逐渐增加靶浓度值直至意识消失.术中调整异丙酚、芬太尼靶浓度值或瑞芬太尼输注速度维持麻醉深度.观察血流动力学、脑电双频指数改变以及麻醉药用量、麻醉后恢复情况.结果3组患者诱导后收缩压(SBP)、舒张压(DBP)明显降低(P<0.05),PR组心率明显减慢(P<0.05),PF,PR组气管插管、切皮后SBP及DBP无明显改变,P组则明显升高(P<0.05).PR,PF组异丙酚麻醉维持用量分别较P组降低32.8%和24.0%(P<0.05).结论瑞芬太尼、芬太尼能明显减少异丙酚用量,抑制气管插管及切皮时的反应,以瑞芬太尼作用明显. Objective To evaluate the influence of remifentanil and fentanyl on anesthetic effect of propofol in total intravenous anesthesia(TIVA). Methods One hundred and ten patients scheduled for elective surgery were randomly divided into propofol group(group P, n=30),propofol-fentanyl group(group PF, n=52) and propofol-remifentanil group(group PR, n=28). The hemodynamic changes and recovery of anesthesia were observed in all patients. The patients were anesthetized with target controlled infusion of propofol and fentanyl(2 μg/L) or continuous infusion remifentanil 0.25~0.5,0.125~0.25 μg/(kg·min) . The initial target plasma concentration of propofol was 1 mg/L and increased gradually until loss of consciousness. Results Blood pressure was significantly lowered in all groups, and HR decreased in PR group after induction of anesthesia(P<0.05). Systolic and diastolic blood pressure increased significantly after intubation and skin incision in group P. The dosage of propofol required for maintenance of anesthesia in group PF and group PR were reduced by 24.0% and 32.8% respectively. Conclusions Remifentanil and fentanyl can significantly reduce the dosage of propofol for loss of conciousness and inhibit the hemodynamic responses to tracheal intubation and skin incision.
作者 赵高峰 张兴安 施冲 吴群林 徐波 Zhao Gaofeng,Zhang Xingan, Shi Chong, et al. Department of Anesthesiology,Guangzhou General Hospital of PLA,Guangzhou 510010
出处 《广东医学》 CAS 2004年第7期 765-767,共3页 Guangdong Medical Journal
基金 广东省科技厅科技计划,军队科研项目
关键词 靶控输注 异丙酚 瑞芬太尼 静脉麻醉 血流动力学 Propofol Remifentanil Fentanyl Total intravenous anesthesia Target controlled infusion
  • 相关文献

参考文献7

  • 1[1]Westmoreland CL, Hoke JF, Sebel PS, et al. Pharmacokinetics of remifentanil (GI87084B) and its major metabolite(GI90291 ) in patients undergoing elective in patient surgery. Anesthesiology, 1993, 79(5):893 被引量:1
  • 2[2]Tackdey RM, Lewis GTR, Prys - Roberts C, et al. Computer controlled infusion of propofol. Br J Anaesth, 1989,62:46 被引量:1
  • 3[3]Shafer SL, Varvel .JR, Aziz N, et al. The performance of phamacokineticparameters derived from a computer controlled infusion pump. Anesthesiology, 1988,69:A460 被引量:1
  • 4张兴安,吴群林,施冲,徐波,戴永忠.异丙酚及氯胺酮靶控输注全静脉麻醉临床应用[J].广东医学,2003,24(1):27-29. 被引量:5
  • 5张兴安,吴群林,聂煌.芬太尼和利多卡因对异丙酚静脉麻醉作用的比较[J].中华麻醉学杂志,2001,21(10):617-620. 被引量:27
  • 6[7]Minto CF, Schnider TW, Egan TD, et al. Influence of age and gender on the pharma cokinetics and pharmacodynamics of remifentanil. I. Model development. Anesthesiology, 1997, 86(1): 10 被引量:1
  • 7[8]Mertens MJ, Olofsen E, Engbers FH, et, al. Propofol reduces perioperative remifentanil requirements in a synergistic manner: response surface modeling of pefioperative remifentanil - propofol interactions. Anesthesiology, 2003,99(2): 347 被引量:1

二级参考文献3

共引文献30

同被引文献454

引证文献100

二级引证文献333

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈