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1、罗呱卡因硬膜外阻滞后异丙酚靶控输注麻醉临床观察【摘要】目的通过脑电双频指数的监测,评价罗呱卡因硬膜外用药后对异丙酚靶控输注(TCI)时麻醉剂量和质量的影响。方法60例接受上腹部手术患者随机分为硬膜外罗呱卡因组(GR)和单纯异丙酚组(PR)二组。GR组硬膜外给药20min后,二组TCI输注异丙酚致意识消失,记录所需时间,继续全麻诱导观察插管反应。所有患者同时监测心电图(ECG),血压(MAP),及脑电双频指数(BIS)并记录异丙酚的效应室浓度(Ce)及用量。结果患者意识消失所需时间及异丙酚的效应室浓度、用量GR组与PR组有统计学显著差异。GR组MAP在硬膜外用药15min、意
2、识消失时、插管后1min,与PR组相比较有显著性差异。结论罗呱卡因硬膜外阻滞可减少异丙酚靶控输注(TCI)时镇静催眠的用量,提高麻醉质量,并缩短意识消失所需的时间,并且有助于血流动力学的平稳,减轻插管反应。【关键词】罗呱卡因;二异丙酚;靶控输注ClinicalstudyoftrachealintubationgeneralanaesthesiawithtargetcontrolledinfusionofpropofolafterepiduralropivaeaineblockYANGXing,HUANGMan,WANGYuanSheng.5DepartmentofAnest
3、hesia,JiangmenCentralHospital,Jiangmen529070,China【Abstract】ObjectiveToevaluatetheeffectoftrachealintubationgeneralanaesthesiawithtargetcontrolledinfusionofpropofolafterepiduralropivaeaineblock.MethodsSixtyASAI～IIpatientsscheduledforupperabdominalsurgerywererandomlyassignedintotwogroups:ro
4、pivaeainegroup,(groupGR,n=30)andpropofolalonegroup,(groupPR,n=30).Twentyminutesafterepidurallocalanestheticsadministration,apropofoltarget-controlledinfusionwasstarteduntiloneminuteaftertrachealintubation.Theconsumedtimeofpatientslosingconsciousness,thetargetconcentrationandtheconsumedamou
5、ntofpropofol,BISandMAPwereallrecordedinfixedtime.ResultsTheconsumedtimeoflosingconseiousness,thetargetconeentrationandtheconsumedamountofpropofolandMAPwereallstatisticallysignificantdifferencebetweentheGRgroupandPRgroup.GRgroupofMAPintheepiduralmedication20minutes,consciousnessdisappears,1
6、5minuteafterintubation,comparedwiththePRgroupweresignificantlydifferent.ConclusionEpiduralropivacaineblockcanenhancethesedativeandhypnoticeffectofpropofoltarget-controlledinfusion,andepiduralropivacaineblockcanimprovethequalityofanesthesia,Andcontributetothesmoothhemodynamic,reducetheintub
7、ationresponse.【Keywords】Ropivacaine;Propofol;Target-controlledinfusion作者单位:529070广东省江门市中心医院麻醉科有研究表明[1]利多卡因硬膜外给药具有强化全身麻醉药的镇静催眠作用,罗呱卡因是否存在相似的效应,目前尚未有相关的报道。本研究拟通过脑电双频指数(BIS)的监测,评价罗呱卡因硬膜外用药后对异丙酚靶控输注(TCI)时麻醉剂量和质量的影响。1资料与方法1.1一般资料病例选择60例胆总管切开取石、胆囊切除的患者,其中男31例,女29例,年
