中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2013年
37期
2997-2999
,共3页
李志华%李富强%徐贯杰%柳顺锁
李誌華%李富彊%徐貫傑%柳順鎖
리지화%리부강%서관걸%류순쇄
静脉麻醉%颈总动脉%二异丙酚%芬太尼%脑电静息
靜脈痳醉%頸總動脈%二異丙酚%芬太尼%腦電靜息
정맥마취%경총동맥%이이병분%분태니%뇌전정식
Anesthesia%Common carotid artery%Propofol%Fentanyl%Electrocerebral
目的 探讨兔异丙酚复合芬太尼颈总动脉注射麻醉的可行性.方法 成年新西兰白兔60只,数字表随机分为4组:PvFv组、PvFa组、PaFv组、PaFa组,每组15例.建立耳缘静脉和对侧颈总动脉液体通道,采用多通道生理监护仪连续监测平均动脉压(MAP)、心电图、心率、脉搏氧饱和度(SpO2)及脑电波.PvFv组经耳缘静脉恒速输注异丙酚30 mg· kg-1·h-1和芬太尼2 μg· kg-1·h-1;PvFa组和PaFv组分别经耳缘静脉和颈总动脉输注异丙酚和芬太尼;PaFa组经颈总动脉同时输注异丙酚和芬太尼.达脑电静息状态时开始计时,之后调节芬太尼输注速度以维持脑电静息状态持续60 min,观察意识消失时间、达脑电静息时间、苏醒时间,各时点的MAP、心率、呼吸频率(RR)、Sp02,以及药物用量.实验结束时,取颈总动脉置管侧远端行形态学观察.结果 (1)除PaFa组,给药达脑电静息时各组兔均呼吸停止而需手控呼吸.(2)达脑电静息即刻时PaFa组异丙酚(5.56±0.26)和芬太尼(0.91±0.15)低于其他组,PvFa与PvFv组比较差异无统计学意义,但均低于PvFv组(20.92±2.89和3.22±0.36);PaFa组异丙酚和芬太尼维持剂量低于其余3组(P＜0.05).(3)PaFa组的给药至意识消失时间(2.87±0.25)、达脑电静息时间(3.92±0.27)及意识恢复时间(5.88±0.52)均明显短于其余3组(P＜0.05),同时PaFv组及PvFa组又短于PvFv组(P＜0.05).(4) PvFv组各时点MAP低于其他各组和基础值(P ＜0.05);PaFa组各时点间MAP、心率差异无统计学意义.(5)各组血管内膜形态无明显改变.结论 兔颈总动脉输注异丙酚复合芬太尼可明显降低用药量,且起效快、苏醒快,对循环、呼吸系统影响轻微,优于耳缘静脉给药方式.
目的 探討兔異丙酚複閤芬太尼頸總動脈註射痳醉的可行性.方法 成年新西蘭白兔60隻,數字錶隨機分為4組:PvFv組、PvFa組、PaFv組、PaFa組,每組15例.建立耳緣靜脈和對側頸總動脈液體通道,採用多通道生理鑑護儀連續鑑測平均動脈壓(MAP)、心電圖、心率、脈搏氧飽和度(SpO2)及腦電波.PvFv組經耳緣靜脈恆速輸註異丙酚30 mg· kg-1·h-1和芬太尼2 μg· kg-1·h-1;PvFa組和PaFv組分彆經耳緣靜脈和頸總動脈輸註異丙酚和芬太尼;PaFa組經頸總動脈同時輸註異丙酚和芬太尼.達腦電靜息狀態時開始計時,之後調節芬太尼輸註速度以維持腦電靜息狀態持續60 min,觀察意識消失時間、達腦電靜息時間、囌醒時間,各時點的MAP、心率、呼吸頻率(RR)、Sp02,以及藥物用量.實驗結束時,取頸總動脈置管側遠耑行形態學觀察.結果 (1)除PaFa組,給藥達腦電靜息時各組兔均呼吸停止而需手控呼吸.(2)達腦電靜息即刻時PaFa組異丙酚(5.56±0.26)和芬太尼(0.91±0.15)低于其他組,PvFa與PvFv組比較差異無統計學意義,但均低于PvFv組(20.92±2.89和3.22±0.36);PaFa組異丙酚和芬太尼維持劑量低于其餘3組(P＜0.05).(3)PaFa組的給藥至意識消失時間(2.87±0.25)、達腦電靜息時間(3.92±0.27)及意識恢複時間(5.88±0.52)均明顯短于其餘3組(P＜0.05),同時PaFv組及PvFa組又短于PvFv組(P＜0.05).(4) PvFv組各時點MAP低于其他各組和基礎值(P ＜0.05);PaFa組各時點間MAP、心率差異無統計學意義.(5)各組血管內膜形態無明顯改變.結論 兔頸總動脈輸註異丙酚複閤芬太尼可明顯降低用藥量,且起效快、囌醒快,對循環、呼吸繫統影響輕微,優于耳緣靜脈給藥方式.
목적 탐토토이병분복합분태니경총동맥주사마취적가행성.방법 성년신서란백토60지,수자표수궤분위4조:PvFv조、PvFa조、PaFv조、PaFa조,매조15례.건립이연정맥화대측경총동맥액체통도,채용다통도생리감호의련속감측평균동맥압(MAP)、심전도、심솔、맥박양포화도(SpO2)급뇌전파.PvFv조경이연정맥항속수주이병분30 mg· kg-1·h-1화분태니2 μg· kg-1·h-1;PvFa조화PaFv조분별경이연정맥화경총동맥수주이병분화분태니;PaFa조경경총동맥동시수주이병분화분태니.체뇌전정식상태시개시계시,지후조절분태니수주속도이유지뇌전정식상태지속60 min,관찰의식소실시간、체뇌전정식시간、소성시간,각시점적MAP、심솔、호흡빈솔(RR)、Sp02,이급약물용량.실험결속시,취경총동맥치관측원단행형태학관찰.결과 (1)제PaFa조,급약체뇌전정식시각조토균호흡정지이수수공호흡.(2)체뇌전정식즉각시PaFa조이병분(5.56±0.26)화분태니(0.91±0.15)저우기타조,PvFa여PvFv조비교차이무통계학의의,단균저우PvFv조(20.92±2.89화3.22±0.36);PaFa조이병분화분태니유지제량저우기여3조(P＜0.05).(3)PaFa조적급약지의식소실시간(2.87±0.25)、체뇌전정식시간(3.92±0.27)급의식회복시간(5.88±0.52)균명현단우기여3조(P＜0.05),동시PaFv조급PvFa조우단우PvFv조(P＜0.05).(4) PvFv조각시점MAP저우기타각조화기출치(P ＜0.05);PaFa조각시점간MAP、심솔차이무통계학의의.(5)각조혈관내막형태무명현개변.결론 토경총동맥수주이병분복합분태니가명현강저용약량,차기효쾌、소성쾌,대순배、호흡계통영향경미,우우이연정맥급약방식.
Objective To compare the pharmacodynamic differences of common carotid artery administration with ear vein administration of propofol and fentanyl in rabbits.Methods Sixty New Zealand white rabbits were randomly divided into four groups (n =15):PvFv,PvFa,PaFv and PaFa groups.Propofol 30 mg · kg-1 · h-1 and fentanyl 2 μg · kg-1 · h-1 were administrated via the ear vein or the common carotid artery.The outcomes were recorded,including the time of consciousness loss and recovery,to electrocerebral silence,dose of propofol and fentanyl,mean arterial pressure,heart rate,respiration rate and SpO2.Results (1) None of rabbits appeared breathing to be depressed seriously in group PaFa,while respiratory in the other groups were significantly depressed.(2)The dosage of propofol and fentanyl of group PaFa was significantly less than the other groups (P ＜ 0.05).(3) The time of consciousness loss and recovery of group PaFa were shorter than the other three groups.Conclusion Compared to drugs infusion via the ear vein,infusion of propol and fentanyl via the common carotid artery is more advantageous in some aspects,such as rapid anesthesia inducation and recovery,smaller dose,and smaller impact on the hemodynamic and respiratory.
