重庆医科大学学报
重慶醫科大學學報
중경의과대학학보
UNIVERSITATIS SCIENTIAE MEDICINAE CHONGQING
2010年
2期
265-267
,共3页
丙泊酚%瑞芬太尼%七氟烷%唤醒试验%脊柱侧弯矫形
丙泊酚%瑞芬太尼%七氟烷%喚醒試驗%脊柱側彎矯形
병박분%서분태니%칠불완%환성시험%척주측만교형
Propofol%Remifentanil%Sevoflurane%Wake-up test%Kyphoscoliosis
目的:评价以丙泊酚瑞芬太尼输注复合七氟烷吸入麻醉方法在脊柱侧弯矫形手术术中唤醒试验的特点.方法:20例脊柱侧弯患者拟行脊柱后路融合手术.瑞芬太尼,丙泊酚和阿曲库铵诱导,以瑞芬太尼0.2μg/(kg·min)和丙泊酚50μg/(kg·min)持续静脉泵注,同时吸入2%七氟烷维持麻醉,间断给予阿曲库铵保持适当的肌肉松弛.手术医师要求唤醒前20min,停止泵注瑞芬太尼、丙泊酚和七氟烷吸入.呼唤病人活动手足,记录停药到患者自主呼吸恢复的时间(T_1),自主呼吸恢复到手足运动的时间(T_2),并评价唤醒试验的质量,同时记录麻醉前、诱导后、停药即刻、唤醒即刻、加深麻醉后的血流动力学变化.结果:患者唤醒即刻的平均动脉压(Mean arterial pressure,MAP)、心率(Heart rate,HR)与停药即刻比较无明显升高(P>0.05),T_1和T_2分别为(4.1±2.0)min和(4.5±2.2)min.18位患者的唤醒试验质量达到满意及以上标准.结论:丙泊酚-瑞芬太尼-七氟烷复合麻醉在脊柱侧弯矫形术中可实现安全快速的唤醒.
目的:評價以丙泊酚瑞芬太尼輸註複閤七氟烷吸入痳醉方法在脊柱側彎矯形手術術中喚醒試驗的特點.方法:20例脊柱側彎患者擬行脊柱後路融閤手術.瑞芬太尼,丙泊酚和阿麯庫銨誘導,以瑞芬太尼0.2μg/(kg·min)和丙泊酚50μg/(kg·min)持續靜脈泵註,同時吸入2%七氟烷維持痳醉,間斷給予阿麯庫銨保持適噹的肌肉鬆弛.手術醫師要求喚醒前20min,停止泵註瑞芬太尼、丙泊酚和七氟烷吸入.呼喚病人活動手足,記錄停藥到患者自主呼吸恢複的時間(T_1),自主呼吸恢複到手足運動的時間(T_2),併評價喚醒試驗的質量,同時記錄痳醉前、誘導後、停藥即刻、喚醒即刻、加深痳醉後的血流動力學變化.結果:患者喚醒即刻的平均動脈壓(Mean arterial pressure,MAP)、心率(Heart rate,HR)與停藥即刻比較無明顯升高(P>0.05),T_1和T_2分彆為(4.1±2.0)min和(4.5±2.2)min.18位患者的喚醒試驗質量達到滿意及以上標準.結論:丙泊酚-瑞芬太尼-七氟烷複閤痳醉在脊柱側彎矯形術中可實現安全快速的喚醒.
목적:평개이병박분서분태니수주복합칠불완흡입마취방법재척주측만교형수술술중환성시험적특점.방법:20례척주측만환자의행척주후로융합수술.서분태니,병박분화아곡고안유도,이서분태니0.2μg/(kg·min)화병박분50μg/(kg·min)지속정맥빙주,동시흡입2%칠불완유지마취,간단급여아곡고안보지괄당적기육송이.수술의사요구환성전20min,정지빙주서분태니、병박분화칠불완흡입.호환병인활동수족,기록정약도환자자주호흡회복적시간(T_1),자주호흡회복도수족운동적시간(T_2),병평개환성시험적질량,동시기록마취전、유도후、정약즉각、환성즉각、가심마취후적혈류동역학변화.결과:환자환성즉각적평균동맥압(Mean arterial pressure,MAP)、심솔(Heart rate,HR)여정약즉각비교무명현승고(P>0.05),T_1화T_2분별위(4.1±2.0)min화(4.5±2.2)min.18위환자적환성시험질량체도만의급이상표준.결론:병박분-서분태니-칠불완복합마취재척주측만교형술중가실현안전쾌속적환성.
Objective:To assess,the characteristics of the wake-up test during compound propofol-remifentanil infusions and sevoflurane inhalation for posterior spinal infusion (PSF) surgery.Methods:Twenty patients with scoliosis and candidates for PSF surgery were studied.After an i.v.bolus of remifentanil 1μg/kg, anesthesia was induced with propofol and atracurium.During maintenance,all patients received infusion of remifentanil 0.2 μg/(kg·min)and propofol 50μg(kg·min)and inhalation of 2% sevoflurane. Atracurium was siren to maintain the required surgical relaxation.At the surgeon's request.all infusions were discontinued.Patients were asked to move their hands and feet.Time from anesthetic discontinuation to spontaneous ventilation(T_1),and from then until movement of the hands and feet (T_2),its quality and hemodynamies were recorded.Resets:T_1 and T_2 were(4.1±2.0)minutes and(4.5±2.2)minutes,respectively.Quality of wake-up test reached satisfactory or good standard in 18 patients. Conclusion: wake-up test can be conducted fast and safely with propfol and remifentanil compound inhalation sevoflurane.
