临床麻醉学杂志
臨床痳醉學雜誌
림상마취학잡지
THE JOURNAL OF CLINICAL ANESTHESIOLOGY
2014年
7期
648-650
,共3页
术中唤醒%脊柱侧弯矫形术%舒芬太尼%瑞芬太尼%丙泊酚
術中喚醒%脊柱側彎矯形術%舒芬太尼%瑞芬太尼%丙泊酚
술중환성%척주측만교형술%서분태니%서분태니%병박분
Wake-up test%Scoliosis surgery%Sufentanil%Remifentanil%Propofol
目的：探讨脊柱侧弯矫形术中丙泊酚复合舒芬太尼或瑞芬太尼静脉全麻对患者术中唤醒质量的影响。方法选择行脊柱侧弯矫形手术患者50例,随机均分为两组,术中持续静脉泵注丙泊酚复合舒芬太尼0.3~0.6μg·kg-1·h-1(SF 组)或瑞芬太尼0.2~0.3μg·kg-1·min-1(RF 组)维持麻醉,术中 BIS 维持在40~60。进行唤醒时,SF 组停止泵入舒芬太尼；RF 组调整瑞芬太尼泵速为0.05μg·kg-1·min-1,直到患者配合指令完成唤醒试验。记录患者的恢复时间(包括出现自主呼吸、体动、能够配合指令的时间)；观察患者唤醒有无躁动；记录两组分别调整用药后10 min(T1)、唤醒时(T2)、唤醒后10 min(T3)的 MAP、HR、PET CO2。结果 RF 组患者的恢复时间明显短于 SF 组(P <0.05)；患者配合指令动脚期间,RF 组的躁动率明显高于 SF 组(P <0.05)；T2时 RF 组 HR 明显快于 SF 组(P <0.05)。结论丙泊酚复合舒芬太尼用于脊柱侧弯矫形术中唤醒质量高,血流动力学更稳定,但唤醒时间相对延长。
目的：探討脊柱側彎矯形術中丙泊酚複閤舒芬太尼或瑞芬太尼靜脈全痳對患者術中喚醒質量的影響。方法選擇行脊柱側彎矯形手術患者50例,隨機均分為兩組,術中持續靜脈泵註丙泊酚複閤舒芬太尼0.3~0.6μg·kg-1·h-1(SF 組)或瑞芬太尼0.2~0.3μg·kg-1·min-1(RF 組)維持痳醉,術中 BIS 維持在40~60。進行喚醒時,SF 組停止泵入舒芬太尼；RF 組調整瑞芬太尼泵速為0.05μg·kg-1·min-1,直到患者配閤指令完成喚醒試驗。記錄患者的恢複時間(包括齣現自主呼吸、體動、能夠配閤指令的時間)；觀察患者喚醒有無躁動；記錄兩組分彆調整用藥後10 min(T1)、喚醒時(T2)、喚醒後10 min(T3)的 MAP、HR、PET CO2。結果 RF 組患者的恢複時間明顯短于 SF 組(P <0.05)；患者配閤指令動腳期間,RF 組的躁動率明顯高于 SF 組(P <0.05)；T2時 RF 組 HR 明顯快于 SF 組(P <0.05)。結論丙泊酚複閤舒芬太尼用于脊柱側彎矯形術中喚醒質量高,血流動力學更穩定,但喚醒時間相對延長。
목적：탐토척주측만교형술중병박분복합서분태니혹서분태니정맥전마대환자술중환성질량적영향。방법선택행척주측만교형수술환자50례,수궤균분위량조,술중지속정맥빙주병박분복합서분태니0.3~0.6μg·kg-1·h-1(SF 조)혹서분태니0.2~0.3μg·kg-1·min-1(RF 조)유지마취,술중 BIS 유지재40~60。진행환성시,SF 조정지빙입서분태니；RF 조조정서분태니빙속위0.05μg·kg-1·min-1,직도환자배합지령완성환성시험。기록환자적회복시간(포괄출현자주호흡、체동、능구배합지령적시간)；관찰환자환성유무조동；기록량조분별조정용약후10 min(T1)、환성시(T2)、환성후10 min(T3)적 MAP、HR、PET CO2。결과 RF 조환자적회복시간명현단우 SF 조(P <0.05)；환자배합지령동각기간,RF 조적조동솔명현고우 SF 조(P <0.05)；T2시 RF 조 HR 명현쾌우 SF 조(P <0.05)。결론병박분복합서분태니용우척주측만교형술중환성질량고,혈류동역학경은정,단환성시간상대연장。
Objective To compare the influence of propofol combined with sufentanil or remifentanil on the quality of wake-up during scoliosis surgery by wake-up test.Methods Fifty pa-tients undergoing scoliosis surgery were randomized into two groups.During the surgery,propofol combined with sufentanily 0.3-0.6 μg·kg-1·h-1 (group SF)or remifentanil 0.2-0.3 μg·kg-1·min-1 (group RF)were continuously infused to maintain anesthesia,and BIS was maintained at 40-60.In wake-up test,the infusion of sufentanyl in group SF was paused and,the infusion rate of remifentanil in group RF was adjusted to 0.05 μg·kg-1·min-1 until the patient completed the wake-up test under instruction.The time that spontaneous breathing occurred,body movement was detected and the capa-bility to follow instructions in both two groups were recorded.MAP,HR,PET CO2 were measured at the time 10 min after medication adjustment (T1 ),waking up(T2 )and 10 min after waking up (T3 ), respectively,in both two groups.Wake-up quality was also recorded.Results The time that sponta-neous breathing occurred,body movement was detected and the capability to follow instructions in group RF were significantly shorter than those in group SF (P <0.05).At T2 the incidence of agita-tion in group RF was significantly higher than that in group SF(P <0.05).And the hemodynamics of group SF were more stable than those of group RF (P <0.05).Conclusion Propofol combined with sufentanil can improve wake-up quality during scoliosis surgery,but the wake-up time is relatively lon-ger.
