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时间:2020-04-24
《右美托咪啶对依托咪酯-瑞芬太尼全麻后躁动的影响-论文.pdf》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、中国实用医药2014年7月第9卷第19期ChinaPracMed,Jul2014。V01.9。N0.19·论著·右美托咪啶对依托咪酯一瑞芬太尼全麻后躁动的影响王子申王福军孔珉珉孙小珊李俊【摘要】目的探讨手术结束前右美托咪啶的使用对依托咪酯一瑞芬太尼全麻后患者躁动的影响。方法100例择期全麻下妇科腹腔镜手术的患者,ASAI~II级,随机分为右美托咪啶组(D组,50例)和对照组(c组,50例),常规麻醉诱导:气管插管后控制呼吸。术中麻醉维持:依托咪酯靶控效应室fArdenMode1)浓度为0.3ml,瑞芬太尼0.20~0.4~tg/(kg·min)持续输注,维库
2、溴铵维持肌松。手术结束前30min接静脉镇痛泵。两组患者均于手术结束前10min停止麻醉药物的输入,用静脉推注泵分别静脉推注生理盐水(C组)和右美托咪啶0.5~ts/kg,推注时间均为10min。比较两组的苏醒、拔管时间、拔管期间患者躁动的情况,观察HR、SBP、DBP、RR的变化。结果镇静和躁动情况与TO比较,C组T2、T4、T5时镇静评分均降低(P<0.05);D组T2、T4~T6时的镇静评分均显著升高(P3、酯静脉麻醉后所致的躁动反应,使血流动力学更趋稳定,且不会使患者苏醒期延长。【关键词】右美托咪啶;全麻苏醒期;气管拔管;镇静;躁动Effectofonagitationafteretomidate-remifentanilgeneralanesthesiaWANGZi-shen,WANGFu-jun,KONGMin—min,eta1.DepartmentofAnesthesiology,AffiliatedHospitalofTaishanMedicalCollege,Taian271000,China【Abstract】OhaectiveToinvestig4、atetheeffectofdexmedetomidineonagitationafteretomidate—remifentanilanesthesiabeforeendofsurgery.MethodsChose100patientswhoundergeneralanesthesialaparoscopicoperation,ASAI~II,randomlydividedthemintodexmedetomidinegroup(groupD,50cases)andcontrolgroup(groupC,50cases),routineanesthesia5、induction,aftertrachealintubation,breathcontrol,maintenanceofanesthesia:etomidatetargetcontrolledefectcompartment(ArdenMode1)concentrationof0.3ml,remifentanil0.20-0.4/xg/(kg‘min)continuousinfusion,vecuroniumtomaintainmusclerelaxation.Operationbeforetheendof30minafterintravenousanal6、gesiapump.Twogroupsofpatientsinoperationbeforetheendofthe10minstopdruginput,usingintravenousinjectionpumpintravenousinjectionofphysiologicalsaline(groupC)anddexmedetomidine0.5s/ks,injectiontimeof10min.Comparedwithtwogroupsofawakening,extubationtime,extubationagitationofpatientswith7、HR,toobservethechangeofsituation;SBP,DBP,RR.AnalysisofdatausingSPSS13statisticalsoftwar.ResultsSedationandagitationconditionscomparedwithTOgroup,RamsayscoredecreasedatT2,T4,T5ingroupC(P8、.GroupDagitationscorewassi
3、酯静脉麻醉后所致的躁动反应,使血流动力学更趋稳定,且不会使患者苏醒期延长。【关键词】右美托咪啶;全麻苏醒期;气管拔管;镇静;躁动Effectofonagitationafteretomidate-remifentanilgeneralanesthesiaWANGZi-shen,WANGFu-jun,KONGMin—min,eta1.DepartmentofAnesthesiology,AffiliatedHospitalofTaishanMedicalCollege,Taian271000,China【Abstract】OhaectiveToinvestig
4、atetheeffectofdexmedetomidineonagitationafteretomidate—remifentanilanesthesiabeforeendofsurgery.MethodsChose100patientswhoundergeneralanesthesialaparoscopicoperation,ASAI~II,randomlydividedthemintodexmedetomidinegroup(groupD,50cases)andcontrolgroup(groupC,50cases),routineanesthesia
5、induction,aftertrachealintubation,breathcontrol,maintenanceofanesthesia:etomidatetargetcontrolledefectcompartment(ArdenMode1)concentrationof0.3ml,remifentanil0.20-0.4/xg/(kg‘min)continuousinfusion,vecuroniumtomaintainmusclerelaxation.Operationbeforetheendof30minafterintravenousanal
6、gesiapump.Twogroupsofpatientsinoperationbeforetheendofthe10minstopdruginput,usingintravenousinjectionpumpintravenousinjectionofphysiologicalsaline(groupC)anddexmedetomidine0.5s/ks,injectiontimeof10min.Comparedwithtwogroupsofawakening,extubationtime,extubationagitationofpatientswith
7、HR,toobservethechangeofsituation;SBP,DBP,RR.AnalysisofdatausingSPSS13statisticalsoftwar.ResultsSedationandagitationconditionscomparedwithTOgroup,RamsayscoredecreasedatT2,T4,T5ingroupC(P8、.GroupDagitationscorewassi
8、.GroupDagitationscorewassi
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