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1、不同靶浓度瑞芬太尼在老年患者胸科手术麻醉中临床分析【摘要】目的探究不同靶❷舛鹊娜氐鸟姨❷尼在老年胸科手术患者麻醉中的应用价值,为临床提供参考。方法87例老年胸科手术患者,根据给予瑞芬太尼浓度的不同分为4、6、8ng/L组,每组29例,对比分析三组患者麻醉时间、意识丧失时间、恢复自主呼吸时间、睁眼时间、拔管时间及不同时间段[TO(进入手术室后平卧lOmin).T1(麻醉诱导后)、T2(插管时)、T3(插管后3min).T4(手术切皮后)、T5(开胸探查时)、T6(手术结束)、T7(拔管)]平均动脉压(MAP)、
2、收缩压(SBP)、心率(HR)水平。结果三组麻醉时间、意识丧失时间、恢复自主呼吸时间、睁眼时间、拔管时间比较差异无统计学意义(P>0.05)4ug/L组在T2、T4、T5时间点的SBP、MAP、HR水平高于TO时间点,而6ug/L组和8ug/L组SBP、MAP、HR水平相对较好;8ng/L组在T1时间点的SBP、MAP、HR水平较TO时降低较为显著;6ug/L组的SBP、MAP、HR水平较其他两组较为良好。结论在老年患者的胸科手术中,使用6卩g/L浓度的瑞芬太尼进行诱导麻醉可有效减轻患者在手术过程中的应激反应
3、,增加患者手术的安全性,值得推广【关键词】瑞芬太尼;胸科手术;靶浓度DOI:10.14163/j.cnki.11-5547/r.2016.33.009ClinicalanalysisofremifentanilbydifferenttargetconcentrationsforanesthesiainsenilethoracicsurgerySHENGSi-yu,XUKai,CHENGYuan-yuan,etal.DepartmentofAnesthesiology,JiangsuHuaianCityHuai
4、yinHospital,Huaian223300,China[Abstract]ObjectiveToinvestigateapplicationvalueofremifentanilbydifferenttargetconcentrationsforanesthesiainsenilethoracicsurgery,andtoprovideclinicalreferenee.MethodsAtotalof87senilethoracicsurgerypatientsweredividedbydifferen
5、tremifentan订concentrationsinto4,6and8ug/Lgroups,with29casesineachgroup・Comparativeanalysiswasmadeonanesthesistime,unconsciousnesstime,autonomousrespirationrecoverytime,eyeopeningtime,extubationtime,andmeanarterialpressure(MAP),systolicbloodpressure(SBP)andh
6、eartrate(HR)levelsinvarioustimepoints[TO(lying10mininoperatingroom),TI(afteranesthesiainduction),T2(duringintubation),T3(3minafterintubation),T4(afteroperationskinincision),T5(duringexploratorythoracotomy),T6(operationending)andT7(extubation)]inthethreegrou
7、ps.ResultsTherewasnostatisticallysignificantdifferenceofanesthesiatime,unconsciousnesstime,autonomousrespirationrecoverytime,eyeopeningtimeandextubationtimeacrossthethreegroups(P>0.05)・4ug/LgrouphadhigherSBP,MAPandHRinT2,T4,T5thanthoseinTO,while6and8ug/Lgro
8、upshadrelativelybetterSBP,MAPandHRlevels.8pg/LgrouphadobviouslylowerSBP,MAPandHRlevelsinT1thanthoseinTO,while6ug/LgrouphadbetterSBP,MAPandHRlevelsthantheothertwogroups.ConclusionImplementofremifentanil