中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2014年
24期
59-61
,共3页
瑞芬太尼%异氟醚%鼓室成形术%控制性降压
瑞芬太尼%異氟醚%鼓室成形術%控製性降壓
서분태니%이불미%고실성형술%공제성강압
Remifentanil%Isoflurane%Tympanoplasty%Controlled hypotension
目的：评价异氟醚复合瑞芬太尼靶控静脉麻醉在鼓室成形术中行控制性降压的应用。方法 ASAⅠ~Ⅱ级需择期行鼓室成形术患者30例，年龄30~50岁，随机分为异氟醚复合瑞芬太尼组（R 组）和异氟醚复合硝普钠组（X 组），连续监测平均动脉压、心率、脉搏血氧饱和度、呼气末二氧化碳分压和心电图，分别记录麻醉诱导前、降压后10 min、降压后30 min 及停止降压后10 min 时的血流动力学变化，计算心率、收缩压乘积，同时记录降压起效时间（开始降压到达到目标血压所需时间）、降压时间、手术时间、术毕拔管时间。结果 R 组与 X 组比较起效时间较慢，但术野质量、术毕拔管时间以及血流动力学稳定性都优于 X 组。结论与常规控制性降压相比，瑞芬太尼靶控静脉麻醉其诱导更平稳，降压效果更优，但由于其代谢更快，术后镇痛应较早开始。
目的：評價異氟醚複閤瑞芬太尼靶控靜脈痳醉在鼓室成形術中行控製性降壓的應用。方法 ASAⅠ~Ⅱ級需擇期行鼓室成形術患者30例，年齡30~50歲，隨機分為異氟醚複閤瑞芬太尼組（R 組）和異氟醚複閤硝普鈉組（X 組），連續鑑測平均動脈壓、心率、脈搏血氧飽和度、呼氣末二氧化碳分壓和心電圖，分彆記錄痳醉誘導前、降壓後10 min、降壓後30 min 及停止降壓後10 min 時的血流動力學變化，計算心率、收縮壓乘積，同時記錄降壓起效時間（開始降壓到達到目標血壓所需時間）、降壓時間、手術時間、術畢拔管時間。結果 R 組與 X 組比較起效時間較慢，但術野質量、術畢拔管時間以及血流動力學穩定性都優于 X 組。結論與常規控製性降壓相比，瑞芬太尼靶控靜脈痳醉其誘導更平穩，降壓效果更優，但由于其代謝更快，術後鎮痛應較早開始。
목적：평개이불미복합서분태니파공정맥마취재고실성형술중행공제성강압적응용。방법 ASAⅠ~Ⅱ급수택기행고실성형술환자30례，년령30~50세，수궤분위이불미복합서분태니조（R 조）화이불미복합초보납조（X 조），련속감측평균동맥압、심솔、맥박혈양포화도、호기말이양화탄분압화심전도，분별기록마취유도전、강압후10 min、강압후30 min 급정지강압후10 min 시적혈류동역학변화，계산심솔、수축압승적，동시기록강압기효시간（개시강압도체도목표혈압소수시간）、강압시간、수술시간、술필발관시간。결과 R 조여 X 조비교기효시간교만，단술야질량、술필발관시간이급혈류동역학은정성도우우 X 조。결론여상규공제성강압상비，서분태니파공정맥마취기유도경평은，강압효과경우，단유우기대사경쾌，술후진통응교조개시。
Objective To evaluate the effect of isoflurane combined with remifentanil target-con-trolled intravenous anesthesia on tympanoplasty. Methods ASA Ⅰ - Ⅱ stage need tympanoplasty in 30 cases,aged 30 - 50 years old,were randomly divided into isoflurane combined with remifentanil group (group R),sodium nitroprusside group(group X),and the levels of MAP,HR,SpO2 ,PET CO2 and ECG were continuously monitored,respectively. Before induction of anesthesia(T1),10 min after hypoten-sion(T2),30 min after hypotension(T3)and stop 10 min after hypotension(T4),the hemodynamic changes of heart rate,systolic blood pressure and calculation of product(RPP)were recorded,buck on-set time(starting antihypertensive to achieve target blood pressure time required),blood pressure reduc-ing time,the operation time,postoperative extubation time were recorded. Results Compared with group X,the onset time in group R was later,but the surgical field quality,postoperative extubation time and hemodynamic changes were better. Conclusions Compared with conventional controlled hypoten-sion,target-controlled intravenous remifentanil anesthesia induces more smoothly,the antihypertensive effect is better, but because of its faster metabolism,postoperative analgesia should be an earlier start.
