丙泊酚复合瑞芬太尼靶控输注对老年上腹部手术患者应激反应和血流动力学的影响

《丙泊酚复合瑞芬太尼靶控输注对老年上腹部手术患者应激反应和血流动力学的影响》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、ABSTRACTObjective：Toobservetheeffectsoftotalintravenousanesthesiawithtarget。controlledinfusion(TCI)ofremifentanilandpropofolonplasmalevelsofCortisol(Cor)，endothelin(ET)，thromboxaneB2(TXB2)andhemodynamicsintheelderlyundergoingupperabdominalsurgerySOthatwecallinvestigatetheelder’Sstressreactionduri

2、ngoperationandanesthesia．Methods：ThirtyASAI—IIpatientsages65-75yrand42·72Kgundergoingupperabdominalsurgerywererandomlydividedintotwogroups．GroupT：target-controlledinfusion(TCI)anesthesia(n=15)；Igroup：intravenous·inhalationanesthesia(n215)．Thepatientswerepremedicated、析mmidazolamO．05mg。k91andartrop

3、ine0．5mgintramuscularinjection30minbeforeanesthesia．GroupT：Anesthesiawasinduced、^，itllpropofolandremifentanilbothgivenbyTCIsimultaneously．Thetargetconcentrationofpropofolwas2—399‘ml—andremifentanilWas4—6ng‘ml一．Whenthepatientslostconsciousness，vecuronium0．15mg‘kg．1wasgivenintravenouslytofacilitate

4、intubation．Targetconcentrationofpropofolandremifentanilwereadjustedtoobtainbloodpressureandheartrate．’nlerateofvecuroniuminfusionWassetat2“g。k分1"mill"1．Stoptoinfusevecuroniumbefore30minutesatthetimeoftheoperationended．WhenthesurgeryWascompleted，thepropofolandremifentanilinfusionwerestoppedabruptl

5、y．GroupI：AnesthesiaWasinduced丽tllfentanyl2-3I_tg’kfflandpropofol1一1．5mg。kg一．Whenthepatientslostconsciousness，vecuronium0．15mg’蝇qwasgivenintravenouslytofacilitateintubation．Anesthesiawasmaintainedwiththeconcentrationof0．6-1．5％isoflurane，therateof2--3J_tg·k百1·h．1fentanyland2昭·k百1．min"1vecuronium．St

6、optoinfuseisofluranebefore15minutesandfcntanylandvecuroniumbefore30minutesatthetimeoftheoperationended．AnintravenouscannulaWasplacedforfluidadministration．Perioperativemonitoringincludedsystolicbloodpressure(SBP)，diastolicbloodpressure(DBP)，meanarterialbloodpressure(MAP)，heartrate(HR)，electrocard

7、iogram(ECG)，peripheraloxygensaturation(Sp02)．Systolicbloodpressure(SBP)，diastolicbloodpressure(DBP)，meanarterialbloodpressure(MAP)，heartrate(HR)wereseparatelyrecordedatthefollowingtimes：baselinebeforeanesthesia(T0，2min