中国医疗前沿
中國醫療前沿
중국의료전연
CHINA HEALTHCARE INNOVATION
2013年
12期
42-43
,共2页
尼卡地平%羟乙基淀粉%单纯静脉麻醉%丙泊酚
尼卡地平%羥乙基澱粉%單純靜脈痳醉%丙泊酚
니잡지평%간을기정분%단순정맥마취%병박분
Nicardipine%Nydroxyethyl starch%Intravenous anesthesia%Propofol
目的观察尼卡地平联合羟乙基淀粉容量填充对单纯静脉麻醉丙泊酚用量的影响。方法将87例择期进行脊柱手术患者随机分为对照组40例和观察组47例，两组在给予尼卡地平开始10-20min内快速静脉滴注10ml/kg羟乙基淀粉130/0.4进行容量填充。观察组在诱导前1min静脉输注尼卡地平10μg/kg，然后以1μg·kg-1·min-1微量泵注入；对照组在相同时间点注射相同剂量的生理盐水。调节丙泊酚浓度使手术中脑电双频指数(BIS)值控制在40-60的范围内。记录丙泊酚用量、拔管时间和清醒时间。结果观察组的丙泊酚用量(850.7±139.3ml)、清醒时间(6.2±2.5)h和拔管时间(8.1±2.6)h 明显少于对照组，差异有统计学意义(P <0.05)；观察组MAP平均值为82.5±15.7，明显比对照组93.5±17.6要低，差异有统计学意义(P <0.05)；观察组HR平均值为90.6±10.5，明显高于对照组75.3±11.5，差异有统计学意义(P <0.05)；观察组术中丙泊酚浓度平均值和BIS平均值分别为2.5±0.4μg/ml和52.8±3.4，分别低于和高于对照组的3.2±0.8μg/ml 和47.5±8.1，差异有统计学意义(P <0.05)。结论尼卡地平联合羟乙基淀粉容量填充对单纯静脉麻醉能减少脊柱手术丙泊酚用量，同时能够保持手术所需麻醉深度，维持血流血压的稳定性，缩短清醒时间和拔管时间，可为外科手术提供良好麻醉。
目的觀察尼卡地平聯閤羥乙基澱粉容量填充對單純靜脈痳醉丙泊酚用量的影響。方法將87例擇期進行脊柱手術患者隨機分為對照組40例和觀察組47例，兩組在給予尼卡地平開始10-20min內快速靜脈滴註10ml/kg羥乙基澱粉130/0.4進行容量填充。觀察組在誘導前1min靜脈輸註尼卡地平10μg/kg，然後以1μg·kg-1·min-1微量泵註入；對照組在相同時間點註射相同劑量的生理鹽水。調節丙泊酚濃度使手術中腦電雙頻指數(BIS)值控製在40-60的範圍內。記錄丙泊酚用量、拔管時間和清醒時間。結果觀察組的丙泊酚用量(850.7±139.3ml)、清醒時間(6.2±2.5)h和拔管時間(8.1±2.6)h 明顯少于對照組，差異有統計學意義(P <0.05)；觀察組MAP平均值為82.5±15.7，明顯比對照組93.5±17.6要低，差異有統計學意義(P <0.05)；觀察組HR平均值為90.6±10.5，明顯高于對照組75.3±11.5，差異有統計學意義(P <0.05)；觀察組術中丙泊酚濃度平均值和BIS平均值分彆為2.5±0.4μg/ml和52.8±3.4，分彆低于和高于對照組的3.2±0.8μg/ml 和47.5±8.1，差異有統計學意義(P <0.05)。結論尼卡地平聯閤羥乙基澱粉容量填充對單純靜脈痳醉能減少脊柱手術丙泊酚用量，同時能夠保持手術所需痳醉深度，維持血流血壓的穩定性，縮短清醒時間和拔管時間，可為外科手術提供良好痳醉。
목적관찰니잡지평연합간을기정분용량전충대단순정맥마취병박분용량적영향。방법장87례택기진행척주수술환자수궤분위대조조40례화관찰조47례，량조재급여니잡지평개시10-20min내쾌속정맥적주10ml/kg간을기정분130/0.4진행용량전충。관찰조재유도전1min정맥수주니잡지평10μg/kg，연후이1μg·kg-1·min-1미량빙주입；대조조재상동시간점주사상동제량적생리염수。조절병박분농도사수술중뇌전쌍빈지수(BIS)치공제재40-60적범위내。기록병박분용량、발관시간화청성시간。결과관찰조적병박분용량(850.7±139.3ml)、청성시간(6.2±2.5)h화발관시간(8.1±2.6)h 명현소우대조조，차이유통계학의의(P <0.05)；관찰조MAP평균치위82.5±15.7，명현비대조조93.5±17.6요저，차이유통계학의의(P <0.05)；관찰조HR평균치위90.6±10.5，명현고우대조조75.3±11.5，차이유통계학의의(P <0.05)；관찰조술중병박분농도평균치화BIS평균치분별위2.5±0.4μg/ml화52.8±3.4，분별저우화고우대조조적3.2±0.8μg/ml 화47.5±8.1，차이유통계학의의(P <0.05)。결론니잡지평연합간을기정분용량전충대단순정맥마취능감소척주수술병박분용량，동시능구보지수술소수마취심도，유지혈류혈압적은정성，축단청성시간화발관시간，가위외과수술제공량호마취。
Objective To investigate the effects of nicardipine hydroxyethyl starch combined with volume expansion on propofol dosage during total intravenous anesthesia. Methods 87 patients undergoing spinal surgery were randomly divided observation group(47 cases) and control group(40 cases). All patients received volume expansion with hydroxyethyl starch 10ml/kg in 20min after giving nicardipine. At 1 min before tracheal intubation,the patients were given a bolus of nicardipine 10μg/kg(observation group) or normal saline(control group), observation group received 10μg/kg nicardipine followed by infusion of 1μg·kg-1·min-1, while control group received the same volume of saline. Anesthesia was maintained with target-controlled by propofol BIS was contolled between 40-60. The consumption of propofol, recovery of consciousness and trachea extubation were recorded. Results The propofol dosage of observation group(850.7±139.3ml), waking hours(6.2±2.5) and extubation time(8.1±2.6) significantly less than in the control group, the difference was statistically significant(P <0.05); The observation group MAP average was 82.5±15.7, was obviously lower than the control group 93.5±17.6, it is statistically significant difference(P <0.05); Observation group HR averages 90.6±10.5, is significantly higher than control group 75.3±11.5, difference has statistical significance(P <0.05); Observation group intraoperative propofol concentration average and BIS average are 2.5±0.4μg/ml and 52.8±3.4, has difference with control group(P <0.05). Conclusion Nicardipine combined with hydroxyethyl starch on the volume expansion during induction could reduce cardiovascular respone, decrease propofol consumption and shorten the time of consciousness recovery and extubation in total intravenous anesthesia.
