中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2011年
6期
664-666
,共3页
右美托咪啶%咪达唑仑%舒芬太尼
右美託咪啶%咪達唑崙%舒芬太尼
우미탁미정%미체서륜%서분태니
Dexmedetomidine%Midazolam%Sufentanil
目的 比较右美托咪啶与咪达唑仑复合舒芬太尼用于肝癌微波治疗术患者麻醉的效果.方法 择期行经皮肝穿刺微波治疗术的肝癌患者40例,男性,ASA分级Ⅱ级,年龄35～62岁,体重45～70 kg,采用随机数字表法,将其随机分为2组(n=20):咪达唑仑组(Ⅰ组)和右美托咪啶组(Ⅱ组).Ⅰ组静脉注射咪达唑仑负荷量40μg/kg,然后静脉输注咪达唑仑40μg·kg-1·h-1;Ⅱ组静脉注射右美托眯啶负荷量1μg/kg,然后静脉输注右美托咪啶0.5μg·kg-1·h-1.两组药物负荷量均用生理盐水稀释至20ml,注射时间均为10 min.负荷量注射完毕后5 min时,静脉注射舒芬太尼负荷量0.2μg/kg,然后采用舒芬太尼行PCIA,背景输注速率0.1μg·kg-1·h-1,PCA量0.1μg/kg,锁定时间3 min.舒芬太尼负荷量注射完毕后2 min开始手术.记录术中心动过缓、心动过速、低血压、高血压和呼吸抑制的发生情况;记录舒芬太尼的PCA总按压次数和有效按压次数.结果 两组心动过缓、心动过速、低血压和高血压的发生率比较差异无统计学意义(P＞0.05);与Ⅰ组比较,Ⅱ组呼吸抑制发生率降低,舒芬太尼PCA总按压次数和有效按压次数减少(P＜0.05).结论 肝癌微波治疗术患者右美托咪啶复合舒芬太尼的麻醉效果优于咪达唑仑复合舒芬太尼.
目的 比較右美託咪啶與咪達唑崙複閤舒芬太尼用于肝癌微波治療術患者痳醉的效果.方法 擇期行經皮肝穿刺微波治療術的肝癌患者40例,男性,ASA分級Ⅱ級,年齡35～62歲,體重45～70 kg,採用隨機數字錶法,將其隨機分為2組(n=20):咪達唑崙組(Ⅰ組)和右美託咪啶組(Ⅱ組).Ⅰ組靜脈註射咪達唑崙負荷量40μg/kg,然後靜脈輸註咪達唑崙40μg·kg-1·h-1;Ⅱ組靜脈註射右美託瞇啶負荷量1μg/kg,然後靜脈輸註右美託咪啶0.5μg·kg-1·h-1.兩組藥物負荷量均用生理鹽水稀釋至20ml,註射時間均為10 min.負荷量註射完畢後5 min時,靜脈註射舒芬太尼負荷量0.2μg/kg,然後採用舒芬太尼行PCIA,揹景輸註速率0.1μg·kg-1·h-1,PCA量0.1μg/kg,鎖定時間3 min.舒芬太尼負荷量註射完畢後2 min開始手術.記錄術中心動過緩、心動過速、低血壓、高血壓和呼吸抑製的髮生情況;記錄舒芬太尼的PCA總按壓次數和有效按壓次數.結果 兩組心動過緩、心動過速、低血壓和高血壓的髮生率比較差異無統計學意義(P＞0.05);與Ⅰ組比較,Ⅱ組呼吸抑製髮生率降低,舒芬太尼PCA總按壓次數和有效按壓次數減少(P＜0.05).結論 肝癌微波治療術患者右美託咪啶複閤舒芬太尼的痳醉效果優于咪達唑崙複閤舒芬太尼.
목적 비교우미탁미정여미체서륜복합서분태니용우간암미파치료술환자마취적효과.방법 택기행경피간천자미파치료술적간암환자40례,남성,ASA분급Ⅱ급,년령35～62세,체중45～70 kg,채용수궤수자표법,장기수궤분위2조(n=20):미체서륜조(Ⅰ조)화우미탁미정조(Ⅱ조).Ⅰ조정맥주사미체서륜부하량40μg/kg,연후정맥수주미체서륜40μg·kg-1·h-1;Ⅱ조정맥주사우미탁미정부하량1μg/kg,연후정맥수주우미탁미정0.5μg·kg-1·h-1.량조약물부하량균용생리염수희석지20ml,주사시간균위10 min.부하량주사완필후5 min시,정맥주사서분태니부하량0.2μg/kg,연후채용서분태니행PCIA,배경수주속솔0.1μg·kg-1·h-1,PCA량0.1μg/kg,쇄정시간3 min.서분태니부하량주사완필후2 min개시수술.기록술중심동과완、심동과속、저혈압、고혈압화호흡억제적발생정황;기록서분태니적PCA총안압차수화유효안압차수.결과 량조심동과완、심동과속、저혈압화고혈압적발생솔비교차이무통계학의의(P＞0.05);여Ⅰ조비교,Ⅱ조호흡억제발생솔강저,서분태니PCA총안압차수화유효안압차수감소(P＜0.05).결론 간암미파치료술환자우미탁미정복합서분태니적마취효과우우미체서륜복합서분태니.
Objective To compare the efficacy of anesthesia with dexmedetomidinc and midazolam combined with sufentanil in patients undergoing microwave coagulation therapy for liver cancer. Methods Forty ASA Ⅱ male patients, aged 35-62 yr, weighing 45-70 kg, scheduled for percutaneous microwave coagulation therapy,were randomly divided into 2 groups ( n = 20 each): midasolam group ( group Ⅰ ) and dexmedetomidine group ( group Ⅱ ). A loading dose of midazolam 40 μg/kg ( in normal saline 20 ml) was given intravenously over 10 min,followed by midasolam infusion at 40 μg·kg-1 ·h-1 in group Ⅰ . A loading dose of dexmedetomidine 1 μg/kg (in normal saline 20 ml ) was given intravenously over 10 min, followed by dexmedetomidine infusion at 0.5 loading dose of sufentanil 0.2 μg/kg was given, and then patient-controlled intravenous anesthesia with sufentsnil (background infusion 0.1 μg·kg-1 ·h-1 , bolus dose 0.1 μg/kg, lockout interval 3 min) was used. The operation was started 2 min after administration of the loading dose of sufentanil. Bradycardia, tachycardia, hypotension, hypertensinn and respiratory depression were recorded. The number of attempts and successfully delivered doses was also recorded. Results There was no significant difference in the incidence of bradycardia, tachycardia, hypotension and hypertension between the two groups ( P ＞ 0 .05). The incidence of respiratory depression was significantly lower, and the number of attempts and successfully delivered doses was smaller in group Ⅱ than in group Ⅰ ( P ＜ 0.05). Conclusion The efficacy of anesthesia with dexmedetomidine and sufentanil is better than that of anesthesia with midazolam and sufentanil in patients undergoing microwave coagulation therapy for liver cancer.
