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ID:15192983
大小:35.50 KB
页数:9页
时间:2018-08-01
《丙泊酚瑞芬太尼靶控全静脉麻醉用于眶内手术》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、丙泊酚瑞芬太尼靶控全静脉麻醉用于眶内手术【摘要】目的观察丙泊酚、瑞芬太尼靶控输注(TCI)全静脉麻醉用于眼眶手术的可行性与安全性。方法择期眶内手术成年患者76例,ASAⅠ~Ⅱ级,随机分为A、B两组各38例。A组以丙泊酚、瑞芬太尼TCI静脉诱导,插管后全程TCI维持麻醉;B组常规诱导插管后,吸入七氟烷+N2O维持。无创心功能血流动力学监测系统全程监测,记录诱导前,气管插管即刻,插管后1、3、5min、切皮、拔管即刻、拔管后1、5min循环动力学变化,停止输注至气管导管拔除时间,麻醉、手术中不良事件及处理。结果两组患者术前一般情况差异无统计学意义,麻醉诱导及维持期间血流动力学均较平稳。A
2、组拔管时间(10.6±2.03)min短于B组(17.14±2.84)min,P=0.031。术后恶心、呕吐(0vs.5,P=0.021);躁动(0vs.4,P=0.04)低于B组(P<0.05)。结论丙泊酚、瑞芬太尼TCI用于眶内手术麻醉,能有效预防麻醉诱导刺激和手术操作应激反应,循环波动小;术野稳定,便于手术操作;术后清醒迅速,彻底,不良反应少,辅以适当术后镇痛,能满足眶内手术需求。【关键词】丙泊酚;瑞芬太尼;靶控输注[Abstract]ObjectiveToinvestigatethefeasibilityandsafetyoftargetcontrolledinfusi
3、on(TCI)withpropofoland9remifentanilintotalintravenousanesthesiaforophthalmicorbitalsurgery.MethodsPropofolandremifentanilTCIwasusedforinductionandmaintenanceingroupA(experimentalgroup).AnesthesiamaintenancewaswithinhaledsevofluranecombinedwithnitrousoxideingroupB(controlgroup)followingconventio
4、nalpracticeintravenously.Esmeronewasinjectedintermittentlyintravenouslytokeepmusclesrelaxingduringtheoperationinbothgroups.Non-invasivehaemodynamicswasmonitorredduringwholestageandchangesofcirculatingparameterswererecordedpre-induction,righttrachealintubationand1,3,5minutespost-intubation,atinc
5、ision,rightextubationand1,5minutespost-extubation,stopofTCItoextubationandadverseeventsandtherapiesduringtheoperationwererecord.Flurbiprofenwasusedforpost-operationpainrelief.ResultsTherewerenostatisticalsignificancesinpatients’ASAgeneralstatusandage,gender,weight,heightbetweentwogroups.Haemody
6、namicsofbothgroupswasstableduringtheprocedures.AwaketimewasmuchshorteringroupAthanthatofingroupB[(10.6±2.03)minvs.(17.14±2.84)min,P=0.031].PostoperativenauseaandvomitingandrestlessnessweremuchhigheringroupAthanthatofingroupB(PONV,0vs.5,P=0.021;restlessness0vs.4,P=0.04).ConclusionPropofol9plusre
7、mifentanilTCIcaneffectivelypreventpatient,whounderwentophthalmicorbitalsurgery,fromstressinducedbyperformanceofanasthesiaandoperation,haemodynamicsiswithlittlefluctuation,thecampusvisualisofoperationismuchstableandeasytomanipulate
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