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ID:33386823
大小:1.50 MB
页数:27页
时间:2019-02-25
《两种椎管内麻醉镇静效应的比较》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、青岛大学硕士学位论文两种椎管内麻醉镇静效应的比较姓名:李晓征申请学位级别:硕士专业:麻醉学指导教师:王世端20120602两种椎管内麻醉镇静效应的比较摘要目的比较腰麻~硬膜外联合麻醉与硬膜外麻醉的镇静效应。方法选择妇科择期开腹手术病人60例,随机数字法分为腰麻~硬膜外联合麻醉镇静组(SE组)与硬膜外麻醉镇静组(E组)。两组病人均控制无痛阻滞平面T6~T8水平,阻滞平面固定后,异丙酚靶控输注镇静,血浆靶控起始浓度为1.2mg/L~,达到预期血浆靶浓度后,每30s上调血浆靶浓度O.2mg/L~,使BIS值达N70,术中维持BIS值在65~75范围内。观察指标两组切皮(To)、腹腔探查
2、,牵拉子宫(T。)、冲洗腹腔(T。)及术毕(Ts)异丙酚效应室浓度及改良O从/S评分;两组异丙酚镇静初始用量、异丙酚总用量、手术时间、镇静时间;比较两组麻黄碱、阿托品使用率、输液量、出血量及硬膜外利多卡因用量。结果与B组比较,A组各时间点异丙酚效应室浓度均明显降低(t=-2.201~2.920,P3、显著性(P>O.05)。结论腰麻~硬膜外联合麻醉与硬膜外麻醉相比,具有更明显的镇静作用。硕士研究生李晓征(麻醉学)指导教师王世端教授关键词:麻醉,脊椎;麻醉,硬膜外;脑电双频指数;二异丙酚Comparisonoftheeffectonsedationoftwomethodsofneuraxialanesthesia:arandomizedcontrolled仃iaL.。AbstractObjectiveTocomparetheeffectofsedationofcombinedspinal-epiduralanesthesiaandepiduralanesthesia.Metho4、dsArandomizedcontrolledtrailwasconductedon60patientsundergoingselectivegynecologicalabdominalsurgery.Womenwererandomlydividedintocombinedspinal—epiduralanesthesiasedationgroup(groupSE)andcpiduralanesthesiasedationgroup(groupE).ThesensoryblocklevelwascontrolledbetweenT6andT8,theTCIofpropofolwa5、sstartedatatargetplasmaconcentrationof1.2mg/Lq,followedbyincrements0.2mg/L.1at30sintervalsuntiltheBISvalueWas70.TheintraopcrativeBISvalueWasmaintainedbetween65and75witllpropofolTCI.Observationindexes111epropofoleffect—siteconcentration.themodifyOAA/Sscore,theonsetdoseandtotaldoseofpropofol,to6、taldoseoflidocaine,thedurationofsurgeryandsedation,therateofephedrineandatropine,thevolumeofintraopcrativetransfusionandbloodloss.ResultsComparedwimgroupB,thepropofoleffect-siteconcentration,theonsetdoseofpropof01.thetotaldoseofpropofolandlidocaineweredecreasedingroupA(P<0.05);therateofephedr7、ineWasincreasedingroupA(P<0.05).TherewgrenodiferenceinthemodifyOAA/Sscore,thedurationofsurgeryandsedation,therateofatropine,thevolumeofintraoperativetransfusionandbloodlossbetweenthetwogroups(尸>0.05).ConclusionCombinedspinal-cpiduralanesthesi
3、显著性(P>O.05)。结论腰麻~硬膜外联合麻醉与硬膜外麻醉相比,具有更明显的镇静作用。硕士研究生李晓征(麻醉学)指导教师王世端教授关键词:麻醉,脊椎;麻醉,硬膜外;脑电双频指数;二异丙酚Comparisonoftheeffectonsedationoftwomethodsofneuraxialanesthesia:arandomizedcontrolled仃iaL.。AbstractObjectiveTocomparetheeffectofsedationofcombinedspinal-epiduralanesthesiaandepiduralanesthesia.Metho
4、dsArandomizedcontrolledtrailwasconductedon60patientsundergoingselectivegynecologicalabdominalsurgery.Womenwererandomlydividedintocombinedspinal—epiduralanesthesiasedationgroup(groupSE)andcpiduralanesthesiasedationgroup(groupE).ThesensoryblocklevelwascontrolledbetweenT6andT8,theTCIofpropofolwa
5、sstartedatatargetplasmaconcentrationof1.2mg/Lq,followedbyincrements0.2mg/L.1at30sintervalsuntiltheBISvalueWas70.TheintraopcrativeBISvalueWasmaintainedbetween65and75witllpropofolTCI.Observationindexes111epropofoleffect—siteconcentration.themodifyOAA/Sscore,theonsetdoseandtotaldoseofpropofol,to
6、taldoseoflidocaine,thedurationofsurgeryandsedation,therateofephedrineandatropine,thevolumeofintraopcrativetransfusionandbloodloss.ResultsComparedwimgroupB,thepropofoleffect-siteconcentration,theonsetdoseofpropof01.thetotaldoseofpropofolandlidocaineweredecreasedingroupA(P<0.05);therateofephedr
7、ineWasincreasedingroupA(P<0.05).TherewgrenodiferenceinthemodifyOAA/Sscore,thedurationofsurgeryandsedation,therateofatropine,thevolumeofintraoperativetransfusionandbloodlossbetweenthetwogroups(尸>0.05).ConclusionCombinedspinal-cpiduralanesthesi
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