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时间:2017-12-07
《丙泊酚-瑞芬太尼合剂用于小儿无肌松气管插管的可行性》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、·1018·实用药物与临床2013年第16卷第11期PracticalPharmacyAndClinicalRemedies.2013。Vo1.16.No.11丙泊酚一瑞芬太尼合剂用于dxJL无肌松气管插管的可行性赵柏松,孟凌新,陈宏志,于铁英[摘要]目的评价在无肌松药条件下丙泊酚一瑞芬太尼合剂(丙一瑞合剂)静脉诱导用于患儿气管插管的临床效果。方法拟行择期手术全身麻醉的患儿29例,ASAI~Ⅱ,年龄1~6岁。麻醉诱导静脉推注负荷剂量丙泊酚2mg/kg后,持续泵注丙一瑞合剂0.3mE/(kg·h)[丙泊酚2.85mg/(kg.h)+瑞芬太
2、尼7.5g/(kg.h)]维持,待BIS值低于60且提下颌无体动时行气管插管。分别记录诱导前(T。)、推注负荷剂量后即刻(T_)、插管前即刻(T2)、插管后即刻(T3)、插管后1min(T4)和插管后3min(]r5)的MAP、HR、SpO2和BIS。插管时根据面罩通气、下颌松弛度、声门暴露、声带运动、呛咳反射、体动反应及插管次数对插管条件进行评价。结果所有患儿均完成气管插管,其中一次插管成功率为96.6%,气管插管条件达优率为94.1%。与¨rn时刻比较,诱导后各时间点HR、MAP、BIS均降低(P<0.05)。与T2时刻比较,T3和
3、T4的HR、BIS升高,T4和T5时刻MAP升高(P<0.05)。插管前后BIS值维持在45~55。结论丙一瑞合剂以0.3mL/(kg-h)持续泵注诱导可为小儿无肌松药条件下气管插管提供良好的插管条件,有效维持血流动力学和麻醉深度的稳定,且未见严重的插管并发症发生。[关键词]丙泊酚;哌啶类;儿童;气管内插管Feasibilityoftrachealintubationwithoutmusclerelaxantinchildrenafteranesthe.siainductionwithpropofol-remifentanilconti
4、nuedinfusionZHAOBal—song,MENGLing—xin,CHENHong—zhi,YuTie—ying(DepatrmentofAnesthesiology,ShengjingHospitalofChinaMedicalUniversity,Shenyang110004.China)[Abstract]ObjectiveToevaluatetheclinicaleffectoftrachealintubationwithoutmusclerelaxantonchildrenafteranesthesiainducti
5、onwithpropofol—remifentanil.Methods29children(ASAI~1I,aged1~6year—old)sched—uledforelectivesurgeryundergeneralanesthesiawereenrolledinthestudy.Anesthesiawasinducedbyintravenousin—jectionataloadingdoseofpropofol2mg/kg,andcontinuedinfusionofpropofol—remifentanilwitharateof
6、0.3mL/(kg-h)[propofol2.85mg/(kg·h)+remifentanil7.5g/(kg·h)].TrachealintubationwasperformedafterBISwasbelow60andnonejawreflex.MAP,HR,SpO2andBISwereseparatelyrecordedbeforeinduction(T0),immedi—atelyafterinjectionofloadingdose(T1),immediatelybeforeandafterintubation(T2andT3
7、),at1and3minafterintu—bation(T4andT5).Intubationconditionswereevaluatedbaseduponeasinessofventilationviafacemask,jawrelaxa—tion,positionofvocalcords,activityofvocalcords,degreeofcoughing,limbmovementandtimesofintubationwhentrachealintubated.ResultsAllchildrenweresuccessf
8、ullyintubated.thesuccessratioofintubationwas96.6%atfirstattemptandsatisfactionrateofintubationcondition
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