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《丙泊酚靶控输注和七氟烷吸入麻醉诱导对老年患者血流动力学的影响.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、·482·ShanghaiMedJ,2014,Vo1.37,No.6●临床麻醉●丙泊酚靶控输注和七氟烷吸入麻醉诱导对老年患者血流动力学的影响黄萍周颖张洁王珊娟杭燕南【摘要】目的以脑电双频指数(BIS)作为麻醉镇静深度监测指标,应用BioZ.com无创血流动力学监测仪监测丙泊酚靶控输注和七氟烷吸入麻醉诱导对老年患者血流动力学的影响。方法选择在气管插管全身麻醉下行择期腹部手术的老年患者4O例,年龄≥65岁,美国麻醉医师学会分级I或Ⅱ级。患者随机分人丙泊酚组和七氟烷组,每组2O例。丙泊酚组采用目标血浆浓度3/,g/mL行静脉麻醉诱导,七氟烷组吸人体积分数为0.0
2、4的七氟烷和纯氧6L/min行吸入麻醉诱导。当BIS值<7O后,静脉注射罗库溴铵0.6mg/kg和芬太尼3~g/kg。待BIS值稳定于45~55且同时满足肌肉松弛药起效时间90s后,行气管插管操作。麻醉诱导全程采用BIS值监测麻醉镇静深度。在麻醉诱导前(T。,基础值)、麻醉诱导后2min(T)、气管插管前1rain(T。)、气管插管即刻(T。)、气管插管后1min(T)、气管插管后3min(T)各时间点,记录患者的无创心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心输出量(CO)、体循环血管阻力(SVR)、左心室做功(LCW)指标
3、。记录在麻醉诱导时的丙泊酚总用量和气管插管时的七氟烷呼气末体积分数。结果麻醉诱导后,两组T至T。和T时间点的HR、MAP和SVR,两组T至Ts时间点的SBP、DBP和LCW,以及七氟烷组T至T。和T时间点的CO均显著低于同组T。时间点(P值均4、O.05)。七氟烷组T和T。至Ts时间点的HR显著低于丙泊酚组同时间点(P值均5、lationonhemodynamicsduringanesthesiainductioninelderlypatientsHUANGPing,ZHOUYing,ZHANGJie,WANGShonjuun,HANGYannan.DepartmentofAnesthesiology,RenjiHospital,ShanghaiJiaotongUniversitySchoolofMedicine,Shanghai200001,ChinaCorrespondingauthor:WANGShanjuan.E-mail:profwangshanjuan@163com6、【Abstract】ObjectiveTocomparetheefectofpropofoltarget-controlledinfusionandsevofluraneinhalationonhemodynamicsmonitoredbyBioZ.comnoninvasivehemodynamicmonitoringsysteminelderlypatientsduringanesthesiainduction,withbispectralindex(BIS)usedassedativeindexMethodsFortyelderlypatientssc7、heduledforabdominaloperationundergeneralanesthesia(AmericanSocietyofAnesthesioIogists~ASA]gradeI一Ⅱ,aged65yearsandmore)wererandomlydividedintogrouppropofolandgroupsevoflurane(n=20each).Afteranintravenousinjectionofmidazolam(0.02mg/kg),thepatientsingrouppropofolreceivedaplasmaconcen8、trationof3ug/mLpropofoltarget—con
4、O.05)。七氟烷组T和T。至Ts时间点的HR显著低于丙泊酚组同时间点(P值均5、lationonhemodynamicsduringanesthesiainductioninelderlypatientsHUANGPing,ZHOUYing,ZHANGJie,WANGShonjuun,HANGYannan.DepartmentofAnesthesiology,RenjiHospital,ShanghaiJiaotongUniversitySchoolofMedicine,Shanghai200001,ChinaCorrespondingauthor:WANGShanjuan.E-mail:profwangshanjuan@163com6、【Abstract】ObjectiveTocomparetheefectofpropofoltarget-controlledinfusionandsevofluraneinhalationonhemodynamicsmonitoredbyBioZ.comnoninvasivehemodynamicmonitoringsysteminelderlypatientsduringanesthesiainduction,withbispectralindex(BIS)usedassedativeindexMethodsFortyelderlypatientssc7、heduledforabdominaloperationundergeneralanesthesia(AmericanSocietyofAnesthesioIogists~ASA]gradeI一Ⅱ,aged65yearsandmore)wererandomlydividedintogrouppropofolandgroupsevoflurane(n=20each).Afteranintravenousinjectionofmidazolam(0.02mg/kg),thepatientsingrouppropofolreceivedaplasmaconcen8、trationof3ug/mLpropofoltarget—con
5、lationonhemodynamicsduringanesthesiainductioninelderlypatientsHUANGPing,ZHOUYing,ZHANGJie,WANGShonjuun,HANGYannan.DepartmentofAnesthesiology,RenjiHospital,ShanghaiJiaotongUniversitySchoolofMedicine,Shanghai200001,ChinaCorrespondingauthor:WANGShanjuan.E-mail:profwangshanjuan@163com
6、【Abstract】ObjectiveTocomparetheefectofpropofoltarget-controlledinfusionandsevofluraneinhalationonhemodynamicsmonitoredbyBioZ.comnoninvasivehemodynamicmonitoringsysteminelderlypatientsduringanesthesiainduction,withbispectralindex(BIS)usedassedativeindexMethodsFortyelderlypatientssc
7、heduledforabdominaloperationundergeneralanesthesia(AmericanSocietyofAnesthesioIogists~ASA]gradeI一Ⅱ,aged65yearsandmore)wererandomlydividedintogrouppropofolandgroupsevoflurane(n=20each).Afteranintravenousinjectionofmidazolam(0.02mg/kg),thepatientsingrouppropofolreceivedaplasmaconcen
8、trationof3ug/mLpropofoltarget—con
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