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ID:37474453
大小:37.00 KB
页数:11页
时间:2019-05-24
《异丙酚-瑞芬太尼靶控输注对妇科腹腔镜手术病人血流动力学影响》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、异丙酚-瑞芬太尼靶控输注对妇科腹腔镜手术病人血流动力学影响作者:张旭彤,李快春,徐旭仲单位:温州医学院第二附属医院麻醉科,浙江温州325027【摘要】目的:观察3.5μg/ml效应室浓度异丙酚联合1.5ECe50(3.6ng/ml)瑞芬太尼效应室靶控输注在妇科腹腔镜手术中对血流动力学的影响,并与吸入麻醉进行比较。方法:30例ASAⅠ级择期腹腔镜手术病人,随机分为两组,即异丙酚联合瑞芬太尼双道静脉效应室靶控输注组(PR组)及七氟烷趸堑胱椋⊿N组),每组15例。监测两组病人围术期的血压、心率(HR
2、)和BIS值;并采用CO2重吸入法测定手术期间的每搏输出量(SV)、心输出量(CO)、体循环阻力(SVR)等血流动力学参数的变化。结果:PR组15例病人血压波动均在适宜麻醉范围内,1例病人在气腹5min时心率低于50次/min而需用阿托品处理;术中PR组所有血流动力学指标均在正常范围内,SN组15例病人中有9例术中血压超出适宜麻醉范围而需静注异丙酚并加大七氟烷吸入浓度加深麻醉;PR组术中气腹15min内各时间点的血压与HR均低于SN组(P<0.05或0.01),PR组术中气腹后的CO与CI均低于SN组
3、(P<0.05或0.01)。结论:吸入麻醉腹腔镜手术中呈高血流动力学状态,异丙酚鸱姨崃习锌厥渥⒙樽淼淖楹夏J奖却澄肼樽砜筛行У乜刂坡樽砗褪质醪僮魉吹难鞫ρП浠【关键词】腹腔镜;二异丙酚;瑞芬太尼;血流动力学HaemodynamicstudyoftargeteffectsiteconcentrationwithpropofolandremifentanilanesthesiaingynecologicallaparoscopicsurgeryZHANGXu-tong*,LI
4、Kuai-chun,XUXu-zhong.﹡*DepartmentofAnesthesiology,theSecondAffiliatedHospitalofWenzhouMedicalCollege,Wenzhou,325027Abstract:Objective:Toinvestigatetheeffectsofpropofol(3.5μg/ml)-1.5ECe50(3.6ng/ml)remifentanilonhemodynamicsandcomparewithinhalationalanest
5、hesiaduringgynecologicallaparoscopicsurgery.Methods:30ASAclassⅠpatientsundergoinggynecologicallaparoscopicsurgerywererandomlydividedintotwogroups:targetingeffect-siteconcertrationofpropofolcombinedwithtargetingeffect-siteconcertrationofremifentanil(PRgroup
6、,n=15)andsevofluranecombinedwithnitrogenmonoxide(SNgroup,n=15).Thehemodynamicparametersforsystolicbloodpressure(SP),diastolicbloodpressure(DP),meanarterialbloodpressure(MAP),heartrate(HR),strokevolume(SV),cardiacoutput(CO),systemicvascularresistance(SVR)an
7、dthedepthofanesthesia(BIS)intwogroupsweremeasuredcontinuouslyduringgynecologicallaparoscopicsurgeryandaroundincisingskin.Results:InthePRgroup,fluctuationofbloodpressureoftotalpatientswasinthesuitablerangeduringlaparoscopicsurgery.Atropinewasinfusedtoonepat
8、ientbecauseoflowerheartrateatthe5minofpneumoperitoneum.IntheSNgroup,propofolwasinfusedandinhalationalconcentrationofsevofluranewasaddedtoninepatientsbecausethebloodpressurewentbeyondthedeterminatenorm.Compare
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