世界最新医学信息文摘（电子版）
世界最新醫學信息文摘（電子版）
세계최신의학신식문적（전자판）
World Latest Medicine Information
2014年
19期
15-16,20
,共3页
靶控输注%效应室靶浓度%脑电双频指数(Bis)
靶控輸註%效應室靶濃度%腦電雙頻指數(Bis)
파공수주%효응실파농도%뇌전쌍빈지수(Bis)
target controlled infusion%target effect site concentration%bispectral index (Bis)
目的：观察丙泊酚联合不同剂量瑞芬太尼靶控输注行全麻诱导时患者血流力学以及脑电双频指数的变化，探讨适用于腹腔镜短小手术的瑞芬太尼诱导剂量。方法选腹腔镜全麻手术病人60例， asa Ⅰ～Ⅱ级，根据靶控输注瑞芬太尼的效应室浓度不同随机分为3组，每组20例，即 e 组（2.0ng/ml）, f 组（3.0ng/ml）和 Q 组（4.0ng/ml）组。丙泊酚血浆靶浓度均为4μg/ml，同时瑞芬太尼行靶控输注，在麻醉诱导过程中，记录病人入室后5min 时刻（t0）、插管前时刻（t1）、插管后1min（t2）、3min（t3）和5min（t4）的心率（Hr）、平均动脉压（MaP）、脑电双频指数（Bis）、瑞芬太尼和丙泊酚用量及预计苏醒时间。结果气管插管后 Q 组 Bis 值明显低于 e 组或 f 组，其中插管后5min 的 Bis 值 Q 组为40±4，e 组为46±6，f 组为44±5）。e 组 MaP 在 t3时刻(81±10)mmHg 仍显著高于 t1时刻（73±9）mmHg，e 组 Hr 在 t3时刻[（81±12）次/min]亦显著高于 t1时刻[（73±12）次/min]。f 组 MaP 仅在 t2时刻[（85±8）mmHg]高于 t1时刻[（72±7）mmHg]，f 组 Hr 在 t2时刻[（82±12）次/min]亦高于 t1时刻[（72±11）mmHg]。Q 组仅 MaP 在 t2时刻[（80±10）mmHg]高于 t1时刻[（70±7）mmHg]，Hr 无显著变化。丙泊酚用量各组相似，瑞芬太尼用量 Q 组高于 e 组和 f 组。预计苏醒时间 e 组和 f 组短于 Q 组。结论丙泊酚联合瑞芬太尼靶控输注行全麻诱导时，随着瑞芬太尼效应室浓度增加 Bis 值逐渐降低并抑制血流力学反应。瑞芬太尼3.0ng/ml 联合丙泊酚血浆靶浓度4μg/ml 靶控输注，应用于腹腔镜短小手术的麻醉。
目的：觀察丙泊酚聯閤不同劑量瑞芬太尼靶控輸註行全痳誘導時患者血流力學以及腦電雙頻指數的變化，探討適用于腹腔鏡短小手術的瑞芬太尼誘導劑量。方法選腹腔鏡全痳手術病人60例， asa Ⅰ～Ⅱ級，根據靶控輸註瑞芬太尼的效應室濃度不同隨機分為3組，每組20例，即 e 組（2.0ng/ml）, f 組（3.0ng/ml）和 Q 組（4.0ng/ml）組。丙泊酚血漿靶濃度均為4μg/ml，同時瑞芬太尼行靶控輸註，在痳醉誘導過程中，記錄病人入室後5min 時刻（t0）、插管前時刻（t1）、插管後1min（t2）、3min（t3）和5min（t4）的心率（Hr）、平均動脈壓（MaP）、腦電雙頻指數（Bis）、瑞芬太尼和丙泊酚用量及預計囌醒時間。結果氣管插管後 Q 組 Bis 值明顯低于 e 組或 f 組，其中插管後5min 的 Bis 值 Q 組為40±4，e 組為46±6，f 組為44±5）。e 組 MaP 在 t3時刻(81±10)mmHg 仍顯著高于 t1時刻（73±9）mmHg，e 組 Hr 在 t3時刻[（81±12）次/min]亦顯著高于 t1時刻[（73±12）次/min]。f 組 MaP 僅在 t2時刻[（85±8）mmHg]高于 t1時刻[（72±7）mmHg]，f 組 Hr 在 t2時刻[（82±12）次/min]亦高于 t1時刻[（72±11）mmHg]。Q 組僅 MaP 在 t2時刻[（80±10）mmHg]高于 t1時刻[（70±7）mmHg]，Hr 無顯著變化。丙泊酚用量各組相似，瑞芬太尼用量 Q 組高于 e 組和 f 組。預計囌醒時間 e 組和 f 組短于 Q 組。結論丙泊酚聯閤瑞芬太尼靶控輸註行全痳誘導時，隨著瑞芬太尼效應室濃度增加 Bis 值逐漸降低併抑製血流力學反應。瑞芬太尼3.0ng/ml 聯閤丙泊酚血漿靶濃度4μg/ml 靶控輸註，應用于腹腔鏡短小手術的痳醉。
목적：관찰병박분연합불동제량서분태니파공수주행전마유도시환자혈류역학이급뇌전쌍빈지수적변화，탐토괄용우복강경단소수술적서분태니유도제량。방법선복강경전마수술병인60례， asa Ⅰ～Ⅱ급，근거파공수주서분태니적효응실농도불동수궤분위3조，매조20례，즉 e 조（2.0ng/ml）, f 조（3.0ng/ml）화 Q 조（4.0ng/ml）조。병박분혈장파농도균위4μg/ml，동시서분태니행파공수주，재마취유도과정중，기록병인입실후5min 시각（t0）、삽관전시각（t1）、삽관후1min（t2）、3min（t3）화5min（t4）적심솔（Hr）、평균동맥압（MaP）、뇌전쌍빈지수（Bis）、서분태니화병박분용량급예계소성시간。결과기관삽관후 Q 조 Bis 치명현저우 e 조혹 f 조，기중삽관후5min 적 Bis 치 Q 조위40±4，e 조위46±6，f 조위44±5）。e 조 MaP 재 t3시각(81±10)mmHg 잉현저고우 t1시각（73±9）mmHg，e 조 Hr 재 t3시각[（81±12）차/min]역현저고우 t1시각[（73±12）차/min]。f 조 MaP 부재 t2시각[（85±8）mmHg]고우 t1시각[（72±7）mmHg]，f 조 Hr 재 t2시각[（82±12）차/min]역고우 t1시각[（72±11）mmHg]。Q 조부 MaP 재 t2시각[（80±10）mmHg]고우 t1시각[（70±7）mmHg]，Hr 무현저변화。병박분용량각조상사，서분태니용량 Q 조고우 e 조화 f 조。예계소성시간 e 조화 f 조단우 Q 조。결론병박분연합서분태니파공수주행전마유도시，수착서분태니효응실농도증가 Bis 치축점강저병억제혈류역학반응。서분태니3.0ng/ml 연합병박분혈장파농도4μg/ml 파공수주，응용우복강경단소수술적마취。
Objective to observe the changes of different doses of propofol combined with remifentanil target controlled infusion for general anesthesia induction in patients with hemodynamic and bispectral index oflaparoscopic operation, suitable for short of remifentanilinduced dose. Methods 60 cases of patients undergoing laparoscopic operation of general anesthesia, asa Ⅰ ~ Ⅱ , according to the effect compartment concentrationwere randomly divided into target controlled infusion of remifentanil into 3 groups, 20 cases in each group, group E (2.0ng/ml), F group (3.0ng/ml) and Q group (group4.0ng/ml). Target plasma concentration of propofol was 4μ g/ml, and remifentanil target controlled infusion in line, induction of anesthesia, records of patients from the moment of 5min (t0), before intubation time (t1), 1min after intubation (t2), 3min (t3) and 5min (t4), heart rate(Hr) average arterial pressure (MaP), bispectral index(Bis), remifentanil and propofol dosage and the expected recovery time. Results after tracheal intubation in Q group Bis was obviously lower than that in e group or f group, the 5min after intubation Bis value of Q group was 40 ± 4, e group was 46 ± 6, f group was 44 ± 5). e MaP at t3 time (81 ± 10) mmHg were still significantly higher than that of T1 moment (73 ± 9) mmHg, E, HR in T3 Group [(81 ± 12) at /min] were significantly higher than that of T1 moment [(73 ± 12) /min]. F MAP only in the T2 Group [(85± 8) when mmHg] is higher than that of T1 moment [(72 ±7) mmHg], F, HR in T2 Group [(82 ± 12) when /min] was also higher than that of T1 moment [(72 ± 11) mmHg]. Group Q was only MaP at the moment of t2 [(80 ± 10)mmHg] higher than that of t1 moment [(70 ± 7) mmHg], Hr had no significant change. The dosage of propofol were similar among the groups, remifentanil group Q washigher than that in E group and f group. estimatedrecovery time of e group and f group were shorter in the Q group. Conclusion Propofol combined with remifentanil target controlled infusion for general anesthesia induction with remifentanil effect compartment concentration increased, BIS value decreased gradually and inhibition of hemodynamic responses. 3.0ng/ml combined with propofol target plasma concentration of remifentanil 4 μ g/ml target controlled infusion, anesthesia for laparoscopic short operation.
