CAJ | 학술논문

目的：观察地佐辛对腹部手术患者七氟醚MACBAR的影响。方法：择期腹部手术患者60例，ASA I或Ⅱ级，年龄30～60岁，随机分为两组（n=30）：对照组（D0组）和地佐辛组（D1组）。麻醉诱导：静脉注射异丙酚2mg/kg、芬太尼3ug/kg、顺阿曲库铵0.15mg/kg，气管插管后行机械通气。 D0组吸入七氟醚，D1组吸入七氟醚的同时静脉缓慢注射地佐辛0.2mg/kg。初始七氟醚呼气末浓度为3.0％。采用改良的序贯法进行试验，切皮时患者的心率或平均动脉压升高幅度≥基础值的15％定义为阳性反应，记录平衡点后各个由阳性反应到阴性反应的中点的浓度，取其平均值，即为MACBAR，计算其95％可信区间。结果：D0组七氟醚的MACBAR为3.04％（95％可信区间为2.84％～3.24％），D1组七氟醚的MACBAR，为2.20％（95％可信区间为1.96％～2.44％），Dl组七氟醚的MACBAR低于D0组（P<0．05）。结论：静脉注射0.2mg/kg地佐辛可以降低腹部手术患者七氟醚MACBAR，增强七氟醚抑制应激反应的效应。
목적：관찰지좌신대복부수술환자칠불미MACBAR적영향。방법：택기복부수술환자60례，ASA I혹Ⅱ급，년령30～60세，수궤분위량조（n=30）：대조조（D0조）화지좌신조（D1조）。마취유도：정맥주사이병분2mg/kg、분태니3ug/kg、순아곡고안0.15mg/kg，기관삽관후행궤계통기。 D0조흡입칠불미，D1조흡입칠불미적동시정맥완만주사지좌신0.2mg/kg。초시칠불미호기말농도위3.0％。채용개량적서관법진행시험，절피시환자적심솔혹평균동맥압승고폭도≥기출치적15％정의위양성반응，기록평형점후각개유양성반응도음성반응적중점적농도，취기평균치，즉위MACBAR，계산기95％가신구간。결과：D0조칠불미적MACBAR위3.04％（95％가신구간위2.84％～3.24％），D1조칠불미적MACBAR，위2.20％（95％가신구간위1.96％～2.44％），Dl조칠불미적MACBAR저우D0조（P<0．05）。결론：정맥주사0.2mg/kg지좌신가이강저복부수술환자칠불미MACBAR，증강칠불미억제응격반응적효응。
Objective:To evaluate the effects of dezocine on the minimum alveolar concentration of sevoflurane for blunting adrenergic responses to skin incision (MACBAR)in patients undergoing abdominal surgery.Methods:Sixty ASA I or 1I patients aged 30-60 yr undergoing elective abdominal surgery were randomly divided into 2 groups (n=30 each);control group (group D0)and dezocine group (group D1).Anesthesia was induced with propofol 2 mg/kg and fentanyl 3ug/kg.Tracheal intubation was facilitated with cisatracurium 0.15 mg/kg.The patients were mechanically ventilated.Anesthesia was maintained with sevoflurane inhalation (the initial end -tidal concentration 3%).Dezocine at 0.2mg/kg was infused at the same time in group D1,The patients’response to skin incision was described as positive if MAP or HR increased by≥15%.If the responoe was positive,the end-tidal concentration of sevoflurane for the next patient was increased by 0.5%,while if negative,decreed by 0.5%.Results:The MACBAR of sevoflurane was 3.04%(95% confidence interval 2.84%~3.24%)in group D0,and 2.20%(95% confidence interval 1.96%~2.44%)in group D1.The MACBAR of sevoflurane was significantly lower in group D1 than in group D0 (P<0.05).Conclusion:Dezocine infusion at 0.2mg/kg can reduce MACBAR of sevoflurane and enhance the inhibitory effect of sevoflurane on the stress response.