广州医科大学学报
廣州醫科大學學報
엄주의과대학학보
Academic Journal of Guangzhou Medical College
2014年
4期
54-57
,共4页
刘晓捷%罗富荣%罗兢聪%陈寰
劉曉捷%囉富榮%囉兢聰%陳寰
류효첩%라부영%라긍총%진환
右美托咪定%丙泊酚%静脉全身麻醉%血压%心率
右美託咪定%丙泊酚%靜脈全身痳醉%血壓%心率
우미탁미정%병박분%정맥전신마취%혈압%심솔
dexmedetomidine%propofol%TIVA%blood pressure%heart rate
目的：观察右美托咪定辅助颈椎手术静脉全麻时丙泊酚用量和对术中血压、心率的影响。方法：选择40例行颈椎手术的颈椎受限患者,随机分成右美托咪定＋丙泊酚＋瑞芬太尼组( D组,n＝20)和生理盐水＋丙泊酚＋瑞芬太尼组( N组,n＝20)。 D组于诱导前10 min静脉泵注右美托咪啶1μg/kg,N组静脉泵注相同容量的生理盐水。术中以瑞芬太尼(血浆浓度,4 ng/mL)和丙泊酚(血浆浓度,据术中血压调节)靶控输注维持麻醉。结果：丙泊酚用量D组、N组分别为(1422.75±180.72)mg和(1902.50±151.64)mg,D组明显减少(P<0.01)；瑞芬太尼用量D组、N组分别为(2617.60±144.68)μg和(2642.25±63.37)μg,两组无明显差异(P>0.05)。术中最低MAP、切皮时、术中最低及术中最高HR,D组明显较低(P<0.05)。组内术前、切皮时和术中最高指标比较,两组MAP均无明显差异( P>0.05),D组术前HR高于切皮时和最高HR,后两者间无明显差异。 N组最高HR大于术前、切皮时HR(P<0.05),后两者间无明显差异(P>0.05)。结论：右美托咪啶辅助颈椎手术静脉全麻显著减少丙泊酚用量,是有效、安全的静脉全麻的辅助用药。
目的：觀察右美託咪定輔助頸椎手術靜脈全痳時丙泊酚用量和對術中血壓、心率的影響。方法：選擇40例行頸椎手術的頸椎受限患者,隨機分成右美託咪定＋丙泊酚＋瑞芬太尼組( D組,n＝20)和生理鹽水＋丙泊酚＋瑞芬太尼組( N組,n＝20)。 D組于誘導前10 min靜脈泵註右美託咪啶1μg/kg,N組靜脈泵註相同容量的生理鹽水。術中以瑞芬太尼(血漿濃度,4 ng/mL)和丙泊酚(血漿濃度,據術中血壓調節)靶控輸註維持痳醉。結果：丙泊酚用量D組、N組分彆為(1422.75±180.72)mg和(1902.50±151.64)mg,D組明顯減少(P<0.01)；瑞芬太尼用量D組、N組分彆為(2617.60±144.68)μg和(2642.25±63.37)μg,兩組無明顯差異(P>0.05)。術中最低MAP、切皮時、術中最低及術中最高HR,D組明顯較低(P<0.05)。組內術前、切皮時和術中最高指標比較,兩組MAP均無明顯差異( P>0.05),D組術前HR高于切皮時和最高HR,後兩者間無明顯差異。 N組最高HR大于術前、切皮時HR(P<0.05),後兩者間無明顯差異(P>0.05)。結論：右美託咪啶輔助頸椎手術靜脈全痳顯著減少丙泊酚用量,是有效、安全的靜脈全痳的輔助用藥。
목적：관찰우미탁미정보조경추수술정맥전마시병박분용량화대술중혈압、심솔적영향。방법：선택40례행경추수술적경추수한환자,수궤분성우미탁미정＋병박분＋서분태니조( D조,n＝20)화생리염수＋병박분＋서분태니조( N조,n＝20)。 D조우유도전10 min정맥빙주우미탁미정1μg/kg,N조정맥빙주상동용량적생리염수。술중이서분태니(혈장농도,4 ng/mL)화병박분(혈장농도,거술중혈압조절)파공수주유지마취。결과：병박분용량D조、N조분별위(1422.75±180.72)mg화(1902.50±151.64)mg,D조명현감소(P<0.01)；서분태니용량D조、N조분별위(2617.60±144.68)μg화(2642.25±63.37)μg,량조무명현차이(P>0.05)。술중최저MAP、절피시、술중최저급술중최고HR,D조명현교저(P<0.05)。조내술전、절피시화술중최고지표비교,량조MAP균무명현차이( P>0.05),D조술전HR고우절피시화최고HR,후량자간무명현차이。 N조최고HR대우술전、절피시HR(P<0.05),후량자간무명현차이(P>0.05)。결론：우미탁미정보조경추수술정맥전마현저감소병박분용량,시유효、안전적정맥전마적보조용약。
Objective: To investigate the effect of propofol consumption with the adjuvant of dexmedetomidine to intraoperative blood pressure and heart rate in patients undergoing cervical operations with total intravenous anesthesia. Methods: 40 patients accepted cervical operations were randomly allocated in two groups:Dexmedetomidine+propofol+remifentanil group ( group D, n= 20 ) , and normal saline+propofol+remifentanil group (group N, n=20). 1.0μg/kg Dexmedetomidine was administered in group D 10 minutes before the induction. Meanwhile the same volume of normal saline was administered in group N. Anesthesia was maintained by a target-controlled infusion ( TCI) of remifentanil ( plasma concentration, 4 ng/mL) and propofol ( plasma concentration, infusion rate regulated by intraoperative blood pressure) . Results:Propofol consumption was significantly less in group D than in group N (1422.75±180.72 vs. 1902.50±151.64;P<0.01). There was no significant difference of remifentanil consumption between the two groups (2617.60±144.6 vs. 2642.25±63.37;P>0.05). The minimal MAP, incision HR, intraoperative minimal and maximum HR in group D was significantly less (P<0.05). Comparing the maximum HR of preoperation, incision and intraoperation in intra-group, there was no significant difference between the two groups in MAPs ( P>0.05) . And pre-operative HR was higher than incision and maximum HR in group D, and there was no significant difference between the latter two indicators. The maximum HR was higher than pre-operative and incision HR in group N ( P<0. 05 ) , and there was no significant difference between the latter two indicators(P>0.05). Conclusion: Dexmedetomidine as an adjuvant can significantly reduce Propofol consumption in total intravenous anesthesia ( TIVA) of cervical operations, which is an effective and safe adjunct to TIVA.
