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ID:33186600
大小:2.57 MB
页数:42页
时间:2019-02-21
《右美托咪定对意识丧失和置入喉罩所需丙泊酚预测效应室浓度的影响》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、复旦大学博士学位论文右美托咪定对意识丧失和置入喉罩所需丙泊酚预测效应室浓度的影响姓名:李春申请学位级别:博士专业:麻醉学指导教师:薛张纲;庄小凤2012-04中文摘要右美托咪定对意识丧失和置入喉罩所需丙泊酚预测效应室浓度的影响目的:探讨右美托咪定对意识丧失和置入喉罩所需丙泊酚的预测效应室浓度的影响。方法:选取复旦大学附属中山医院2012年2月1日至3月31日期间,择期行泌尿外科输尿管镜/膀胱镜手术的男性患者40例,年龄18.65岁,BMll5.30kg/m2,ASAI-II级,随机分为右美托咪啶组与对照组。右美托咪定组于诱导前10
2、min内恒速输注右美托咪定lug/kg,对照组输注等容积生理盐水。靶控输注丙泊酚诱导,并逐渐增加靶控血浆浓度直至意识消失,记录两组病人意识丧失时丙泊酚预测效应室浓度,通过改良Dixon序贯法【1】(ModifyingDixon’supanddownmethod)确定置入喉罩时所需丙泊酚的预测效应室浓度。结果:右美托咪定组和对照组意识丧失时丙泊酚预测效应室浓度分别为1.03±0.19ug/ml和2.28±0.12ug/ml(P<0.05);右美托咪定组和对照组在50%病人成功置入喉罩时的丙泊酚预测效应室浓度(ECs0LMI)分别为2
3、.85ug/rra(95%CI:2.52~3.19ug/m1)和4.09ug/ml(95%CI:3.68~4.59ug/m1)。结论:诱导前输注右美托咪定lug/kg可分别减少男性病人意识丧失时和50%病人成功置入喉罩时的丙泊酚预测效应室浓度45%和30%。关键词:右美托咪定喉罩丙泊酚靶控输注中图分类号:R614.2+4AbstractDexmedetomidinepretreatmentreducespredictedeffect-site‘‘‘“pro[}fo’luiredforlossconcentrationOIDroDo
4、IolreqUirellofconSCl。OUsness0ICandLaryngealMaskAirwayinsertionobjective:Toinvestigatetheeffectofdexmedetomidineonthepredictedeffect-siteconcentrationofpropofolrequiredforlossofconsciousness(LOC)andLaryngealMaskAirway(LMA)insertion.Methods:40ASAphysicalstatus1and2men,a
5、gebetween18—65-yearold,BMI15-30,scheduledforminorurologicalprocedures.Patientswererandomlyallocatedtoadexmedetomidinegrouporacontrolgroup.TenminutesbeforepropofolTCIinduction,dexmedetomidinegrouppatientsreceiveddexmedetomidinelug/kg,whilecontrolgrouppatientsreceivedsa
6、line.Propofolwasgiveninatarget-controlledinfusionandtargetbloodconcentrationwasgraduallyincreaseduntilLOC.Theeffect-siteconcentrationsforattemptingLMAinsertionWaspredeterminedbymodifyingDixon’Supanddownmethod.LMAinsertionWasattemptedwithoutmuscularblockingagents.Resul
7、ts:Theeffect-siteconcentrationofpropofolrequiredforLOCWas2.28±0.12ug/mlforthecontrolgroupand1.03±0.19ug/mlforthedexmedetomidinegroup(P<0.05).Thepredictedeffect-siteconcentrationofpropofolaloneatwhich50%ofpatientssucceededinLMAinsertion(ECsoLMI)Was4.09ug/ml(95%CI:3.68-
8、4.59ug/m1).Pretreatmentwimdexmedetomidinelug/kgdecreasedEC50LMIto2.85ug/ml(95%CI:2.52~3.19ug/m1).Conclusion:Pretreatmentwith
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