国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2012年
8期
1138-1140
,共3页
罗哌卡因%硬膜外%丙泊酚靶控输注
囉哌卡因%硬膜外%丙泊酚靶控輸註
라고잡인%경막외%병박분파공수주
Ropivacaine%Epidural%Target-controlled infusion of propofol
目的 探讨罗哌卡因(ropivacaine,RPC)硬膜外用药后对胃肠肿瘤手术患者全麻诱导期丙泊酚靶控输注(TCI)时脑电双频指数(BIS)的影响及机制.方法 40例患者随机分为硬膜外生理盐水组(GC)和硬膜外RPC组(GR),硬膜外穿刺置管成功后连接BIS,设定丙泊酚TCI的效应室浓度2.5μg/mL维持麻醉,手术开始前15 min硬膜外给药,GC组用0.9％的生理盐水,GR组用0.75％的RPC,首次剂量10ml,然后以5 ml/h持续硬膜外注射,记录患者麻醉维持时的BIS值.结果 清醒状态两组BIS值差异无显著性(P＞0.05),手术后GC组30 min BIS值平均85.46、GR组BIS值平均80.33,60 min GC组BIS值80.19、GR组BIS值72.51,两组患者BIS值显著降低(P＜0.05).结论 硬膜外RPC阻滞显著降低丙泊酚TCI麻醉时的BIS值,增强了镇静深度,可适度减少丙泊酚的用量,提高手术的安全性.
目的 探討囉哌卡因(ropivacaine,RPC)硬膜外用藥後對胃腸腫瘤手術患者全痳誘導期丙泊酚靶控輸註(TCI)時腦電雙頻指數(BIS)的影響及機製.方法 40例患者隨機分為硬膜外生理鹽水組(GC)和硬膜外RPC組(GR),硬膜外穿刺置管成功後連接BIS,設定丙泊酚TCI的效應室濃度2.5μg/mL維持痳醉,手術開始前15 min硬膜外給藥,GC組用0.9％的生理鹽水,GR組用0.75％的RPC,首次劑量10ml,然後以5 ml/h持續硬膜外註射,記錄患者痳醉維持時的BIS值.結果 清醒狀態兩組BIS值差異無顯著性(P＞0.05),手術後GC組30 min BIS值平均85.46、GR組BIS值平均80.33,60 min GC組BIS值80.19、GR組BIS值72.51,兩組患者BIS值顯著降低(P＜0.05).結論 硬膜外RPC阻滯顯著降低丙泊酚TCI痳醉時的BIS值,增彊瞭鎮靜深度,可適度減少丙泊酚的用量,提高手術的安全性.
목적 탐토라고잡인(ropivacaine,RPC)경막외용약후대위장종류수술환자전마유도기병박분파공수주(TCI)시뇌전쌍빈지수(BIS)적영향급궤제.방법 40례환자수궤분위경막외생리염수조(GC)화경막외RPC조(GR),경막외천자치관성공후련접BIS,설정병박분TCI적효응실농도2.5μg/mL유지마취,수술개시전15 min경막외급약,GC조용0.9％적생리염수,GR조용0.75％적RPC,수차제량10ml,연후이5 ml/h지속경막외주사,기록환자마취유지시적BIS치.결과 청성상태량조BIS치차이무현저성(P＞0.05),수술후GC조30 min BIS치평균85.46、GR조BIS치평균80.33,60 min GC조BIS치80.19、GR조BIS치72.51,량조환자BIS치현저강저(P＜0.05).결론 경막외RPC조체현저강저병박분TCI마취시적BIS치,증강료진정심도,가괄도감소병박분적용량,제고수술적안전성.
Objective To investigate the impact and mechanism of ropivacaine epidural anesthesia on the values of bispectral index (BIS) in patients with gastrointestinal tumors when propofol target-controlled infusion (TCI).Methods 40 patients were randomly divided into the epidural saline group (GC) and epidural RPC Group (GR),after the success of epidural catheterization connection BIS,set the TCI propofol effect-site concentration 2.5 μg/mL to maintain anesthesia,epidural administration at 15 min before surgery,GC group with 0.9％ saline,GR group with 0.75％ of the RPC.The first dose was 10 ml,then 5 ml/h continuous epidural injection recorded the BIS values.Results Two awake group showed no significant difference in BIS values(P＞0.05),BIS 30 min after operation in group GC,group GR values by an average of 85.46,BIS average of 80.33 of GR group,BIS 80.19 for 60 min GC group,BIS 72.51 for GR group,BIS of patients in two groups significantly reduced (P＜0.05).Conelusion Ropivacaine epidural anesthesia significantly can reduce the BIS values with propofol TCI, enhance the depth of sedation.It may be appropriate to reduce the amount of propofol and inprove the safety of operation.
