CAJ | 학술논문

目的：观察丙泊酚-雷米芬太尼复合麻醉-喉罩（ LMA）通气在腹主动脉瘤血管腔内隔绝术（ EVGE）麻醉中的临床效果。方法15例行腹主动脉瘤EVGE的患者，在充分的术前准备后，入室静脉注射东莨菪碱0．01 mg· kg-1，麻醉诱导用丙泊酚1．5～2．0 mg· kg-1、维库溴胺0．08 mg· kg-1、雷米芬太尼2～4μg· kg-1， LMA通气；继以丙泊酚4 mg· kg -1· h-1和雷米芬太尼8μg· kg-1· h-1持续泵入维持。连续监测无创及有创血压、心率。结果麻醉诱导和术中的血压和心率比麻醉前明显下降（P＜0．05）；插入喉罩及术毕时心率和血压比麻醉诱导后略有增快与升高，但差异无统计学意义（ P＞0．05）。结论丙泊酚-雷米芬太尼麻醉-LMA通气应用于腹主动脉瘤EVGE安全有效。
목적：관찰병박분-뢰미분태니복합마취-후조（ LMA）통기재복주동맥류혈관강내격절술（ EVGE）마취중적림상효과。방법15례행복주동맥류EVGE적환자，재충분적술전준비후，입실정맥주사동랑탕감0．01 mg· kg-1，마취유도용병박분1．5～2．0 mg· kg-1、유고추알0．08 mg· kg-1、뢰미분태니2～4μg· kg-1， LMA통기；계이병박분4 mg· kg -1· h-1화뢰미분태니8μg· kg-1· h-1지속빙입유지。련속감측무창급유창혈압、심솔。결과마취유도화술중적혈압화심솔비마취전명현하강（P＜0．05）；삽입후조급술필시심솔화혈압비마취유도후략유증쾌여승고，단차이무통계학의의（ P＞0．05）。결론병박분-뢰미분태니마취-LMA통기응용우복주동맥류EVGE안전유효。
Objective To observe the outcomes of propofol -remifentanil anesthesia with laryngeal mask airway ventilation during endovascular graft exclusion (EVGE) of abdominal aortic aneurysm .Methods Propofol-remifentanil anesthesia with LMA was performed in 15 patients undergoing EVGE of abdominal aortic aneurysm .Isntravenous scopol-amine 0.01 mg· kg-1 was injected before anesthesia .Anesthesia induction was carried out with propofol 1.5-2.0 mg· kg-1 , vecuronium 0.08 mg/kg, remifentanil 2-4 μg· kg-1 , and which was followed by LMA ventilation .Anesthesia was maintained by infusion of propofol 4 mg· kg-1 · h-1 and remifentanil 8 μg· kg-1 · h-1 .Continuous non-invasive and invasive BP and HR were monitored .Result BP and HR dring anesthetic induction and operation were significantly reduced than those before anesthesia (P<0.05).BP and HR were slightly increased during LMA insertion and opera-tion, but with no statistical difference (P>0.05).Conclusion Propofol-remifentanil anesthesia with LMA ventilatin can be used safely and effectively in abdominal aortic aneurysm undergoing EVGE .