舒芬太尼靶控输注对异氟醚吸入麻醉苏醒期躁动防治的临床观察.doc

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1、舒芬A尼靶控输注对异氟瞇吸入麻醉苏醞期躁动防治的临床观察作者：杨少勇，郭东勇单位：300060天津市，天津医科大学肿瘤医院麻醉科【摘要】目的观察舒芬太尼效应室靶控输注(TCI)对异氟瞇吸入麻醉苏醒时躁动的防治作用，并与舒芬太尼间断静脉推注做比较。方法71例择期开腹手术患者，ASAI〜II级，随机分为舒芬太尼效应室靶控输注(TCI纽.)和舒芬太尼间断静脉推注(对照组)，TCI组效应室浓度(Ce)根据麻醉深度变动于0.2〜0.5ng/ml,对照组诱导吋负荷量0.3μg/kg后间断推注舒芬太尼5~15μg,TCI31Ce拔管靶浓度设定为

2、0.2ng/ml。结果拔管时间与苏醒时间2纽•无明显不同，躁动分级≥5级的发生率TCI纽.⑵36)远少于对照纽(8/35)(P<0.05)。拔管时血流动力学波动及呼吸抑制情况2纽•大致相同(P>0.05),术毕启用镇痛泵的时间TCI给药组明显长于对照ai.(P<0.05)o结论异氟醛吸入麻醉复合舒芬太尼采用TCI的给药方式，0.2ng/mlCe作为拔管时设定的靶浓度，无呼吸抑制，随后的苏醒过程顺利，躁动明显少于舒芬太尼间断推注维持镇痛的方法，且有利于术后早期的镇痛。【关键词】舒芬太尼;异氟醸;靶控输注;苏醒期躁动;并发

3、症InfluenceofsufentaniltargetcontrolledinfusiononemergenceagitationafterisofluraneinhalationanesthesiaYANGShaoyong,GUODongyong.DepiirtmentofAnesthesiology,CancerHospitalofTianjinMedicalUniversity,Tianjin300060,China[Abstract]ObjectiveTocomparetheeffectsoftargetcontrolledinfu

4、sionandintermittentinfusionofsufentanylonrestlessnessafterisotlurane/sutentanilanaesthesia.MethodsThe71(ASAI〜II)patientsundergoingopenabdominalprocedureswererandomlydividedintotwogroups,the36patientsinTCIgroupreceivedsufentaniltargetcontrolledinfusionwitheffectcompartmentco

5、ncentration(Ce)0.5〜0・2ng/ml,AtthetimeofextubationCetargetat0.2ng/iTil,however,the35patientsincontrolgroupreceivedisofluraneintravenouspush,firstlywith0.3μg/kgloadingdosefollowedby5~15μgintermittentlyintravenouspushduringoperation.ResultsTherewasnosignificantdifference

6、betweentwogroupsinthetimeofextubationandawaking.Thecaseshigherthan5degreeofrestlesnessweresignificentlylessinTCIgroup(2/36)thanthoseincontrol(8/35,P<0.05).ImplementofthepatientbycontrolledanalgesiawaslaterinTCIgroupthanthatincontrolgroup[(222±32)minvs(66±45

7、)min,P<0・05].ConclusionDuringtheanesthesiaofisoflurane/sufentani1,theTCIofsufentanilCeof0.2ng/mlissuitableforextubation.Therestlessnessandrespiratorycomplicationsaredecreased,whichalsocanprovidesatisfactoryearlypostoperativeanalgesia.【Keywords]sufentcinyl;isoflurane;targ

8、etcontrolledinfusion;emergenceagitation;complication全麻苏醒期躁动(restlessness)是麻醉医生、外科医