包头医学院学报
包頭醫學院學報
포두의학원학보
Journal of Baotou Medical College
2015年
9期
7-9
,共3页
瑞芬太尼%甲状腺次全切除术%血糖
瑞芬太尼%甲狀腺次全切除術%血糖
서분태니%갑상선차전절제술%혈당
Remifentanil%Subtotal thyroidectomy%Blood sugar
目的:观察不同剂量的瑞芬太尼在甲状腺次全切除术中对血液动力学和血糖的影响. 方法:择期甲状腺次全切除术患者200例,ASAⅠ-Ⅱ级,随机分为4组,每组50例,行双侧颈丛神经阻滞. 术前5 min给予咪唑安定(0.04 mg/kg),同时给相应剂量瑞芬太尼〔R2组0.025 μg/(kg· min),R3组0.05 μg/(kg· min),R4组0.075 μg/(kg· min)〕或氟芬合剂(R1组氟哌利多5 mg、芬太尼0.1 mg合剂)静脉注射,分别记录各时间点的平均动脉压(mean artery pressure,MAP)、心率(heart rate,HR)、血氧饱和度(oxygen saturation, SpO2 )及血糖浓度. 观察呼吸抑制、恶心、呕吐、皮肤瘙痒等不良反应,记录镇静、镇痛、术中配合和术后满意度评分. 结果:组间比较, R3组和R4组的T3、T4时点MAP均明显低于R1组( P <0.01),R3组T4时点HR显著低于R1组( P <0.01);R3组F5时点和R4组 F4、F5时点血糖明显低于R1组( P <0.05);R4组F4、F5时点血糖均明显低于R1组( P <0.01);R3、R4组镇静、镇痛、术中配合、术后遗忘和满意度与R1、R2组比较,差异具有统计学意义( P <0.05). 结论:0.05 μg/kg瑞芬太尼复合0.04 mg/kg咪唑安定用于颈丛神经阻滞,可使术中血液循环保持稳定,有效抑制血糖升高,可用于甲状腺次全切除术中.
目的:觀察不同劑量的瑞芬太尼在甲狀腺次全切除術中對血液動力學和血糖的影響. 方法:擇期甲狀腺次全切除術患者200例,ASAⅠ-Ⅱ級,隨機分為4組,每組50例,行雙側頸叢神經阻滯. 術前5 min給予咪唑安定(0.04 mg/kg),同時給相應劑量瑞芬太尼〔R2組0.025 μg/(kg· min),R3組0.05 μg/(kg· min),R4組0.075 μg/(kg· min)〕或氟芬閤劑(R1組氟哌利多5 mg、芬太尼0.1 mg閤劑)靜脈註射,分彆記錄各時間點的平均動脈壓(mean artery pressure,MAP)、心率(heart rate,HR)、血氧飽和度(oxygen saturation, SpO2 )及血糖濃度. 觀察呼吸抑製、噁心、嘔吐、皮膚瘙癢等不良反應,記錄鎮靜、鎮痛、術中配閤和術後滿意度評分. 結果:組間比較, R3組和R4組的T3、T4時點MAP均明顯低于R1組( P <0.01),R3組T4時點HR顯著低于R1組( P <0.01);R3組F5時點和R4組 F4、F5時點血糖明顯低于R1組( P <0.05);R4組F4、F5時點血糖均明顯低于R1組( P <0.01);R3、R4組鎮靜、鎮痛、術中配閤、術後遺忘和滿意度與R1、R2組比較,差異具有統計學意義( P <0.05). 結論:0.05 μg/kg瑞芬太尼複閤0.04 mg/kg咪唑安定用于頸叢神經阻滯,可使術中血液循環保持穩定,有效抑製血糖升高,可用于甲狀腺次全切除術中.
목적:관찰불동제량적서분태니재갑상선차전절제술중대혈액동역학화혈당적영향. 방법:택기갑상선차전절제술환자200례,ASAⅠ-Ⅱ급,수궤분위4조,매조50례,행쌍측경총신경조체. 술전5 min급여미서안정(0.04 mg/kg),동시급상응제량서분태니〔R2조0.025 μg/(kg· min),R3조0.05 μg/(kg· min),R4조0.075 μg/(kg· min)〕혹불분합제(R1조불고리다5 mg、분태니0.1 mg합제)정맥주사,분별기록각시간점적평균동맥압(mean artery pressure,MAP)、심솔(heart rate,HR)、혈양포화도(oxygen saturation, SpO2 )급혈당농도. 관찰호흡억제、악심、구토、피부소양등불량반응,기록진정、진통、술중배합화술후만의도평분. 결과:조간비교, R3조화R4조적T3、T4시점MAP균명현저우R1조( P <0.01),R3조T4시점HR현저저우R1조( P <0.01);R3조F5시점화R4조 F4、F5시점혈당명현저우R1조( P <0.05);R4조F4、F5시점혈당균명현저우R1조( P <0.01);R3、R4조진정、진통、술중배합、술후유망화만의도여R1、R2조비교,차이구유통계학의의( P <0.05). 결론:0.05 μg/kg서분태니복합0.04 mg/kg미서안정용우경총신경조체,가사술중혈액순배보지은정,유효억제혈당승고,가용우갑상선차전절제술중.
Objective:To observe the effect of anesthesia with different doses of remifentanil on haemodynamics and blood sugar concentration in subtotal thyroidectomy.Methods:200 ASA Ⅰ ~Ⅱ patients undergoing subtotal thyroidectomy with bilateral cervical plexus nerve block were randomly divided into four groups ( n =50 ).The patients were injected midazolam 0.04 mg/kg 5 minutes before operation, and at the same time they were given the corresponding doses of remifentanil (group R2 0.025μg/kg/min, group R3 0.05μg/kg/min, group R4 0.075μg/kg/min) or innovar intravenously (group R1 droperido 15mg, fentanly 0.1mg mixtures).The mean arterial pressure (MAP), heart rate (HR), arterial oxy-gen saturation (SpO2), and blood sugar concentration at each given time were recorded respectively.The adverse reactions including respiratory depression, nausea, vomiting, and itch of skin were observed, and appeasement, analgesia during surgery, intraoperative coordination and degree of satisfaction after operation were recorded.Results:In group R3 and R4, MAP at T3 and T4 was significantly higher than that in group R1( P <0.01)and HR of group R3 at T4 was significantly lower than that of group R1( P <0.01).Blood sugar concentration in group R3 at F5 and in group R4 at F4 and F5 was significantly lower than that in group R1( P <0.05).Compared with R1 and R2, there were statistically significant differences in appeasement, analgesia during surgery, intraoperative coordination and degree of satisfaction after operation in group R3 and R4( P<0.05).Conclusion:The application of remifentanil 0.05μg/kg/min combined with midazolam 0.04mg/kg in cervical plexus nerve block ena-bles blood circulation during operation to remain stable and the increase of blood glucose to be suppressed effectively .It can be used in subtotal thy-roidectomy.
