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1、异丙酚靶控输注用于口腔颌面外科盲探插管麻醉的效果评价上海口腔医学2004年10月第13卷第5期ShanghaiJournalofStomatologyVo1.13No.5October,2004?375?[文章编号]1006—7248(2004)05—0375—04异丙酚靶控输注用于口腔颌面外科盲探插管麻醉的效果评价姜虹.朱也森(上海第二医科大学附属第九人民医院麻醉科,上海200011)【摘要】目的:观察异丙酚靶控输注cI)用于口腔颌面外科盲探插管麻醉的效果.方法:将80例口腔颌面外科气道困难病例等分为4组,均采用盲探气管插管新技术插管.插管前,组I,组Ⅱ,组m给予芬太尼4
2、g,并分别按1.0lag/ml,1.5ml,2.0~Jml的靶血药浓度实施异丙酚TCI;组Ⅳ仅给予芬太尼41~g/kg.所有患者均用局麻药完善气管内表面麻醉,观察比较4组插管的麻醉效果.结果:组Ⅱ和组Ⅲ的Ramsay镇静评分较用药前明显上升.插管中其分值也显着高于其他组(P<0.05);插管中,组Ⅱ和组Ⅲ的MAP,HR稳定;组I和组Ⅳ显着上升(P<0.05);插管中,4组RR均明显下降,其中,以组Ⅲ最为明显(P<0.05),但4组的SpO:,0均无显着变化;4组的血浆PRL和血浆AⅡ插管后较插管前均有不同程度的明显上升,组Ⅳ升幅明显高于组nl(P<0
3、.05).结论:异丙酚靶控输注有助于完善盲探插管麻醉.在控制合适靶血药浓度的前提下,这种方法是安全可行的.【关键词】口腔颌面外科麻醉;气道困难;盲探插管;靶控输注;异丙酚【中图分类号1R782.05.4【文献标识码】AStudyofpropofoltargetcontrolledinfusionforblindtrachealintubationinanesthesiaoforalandmaxfllofacialsurgeryJIANGHong,ZHUYe-sen.(DepartmentofAnesthesiology,NinthPeople'sHospital,棚咖Sec
4、ondMedicalUniversity.Shanghai200011,China)【AI~ract]PURPOSE:ToobservetIleclinicaleffectsofpmpofoltargetcontrolledinfusionforblindtrachealintubationinaRestIlesiaoforalandmaxillofacialsurgery.METHODS:80caseswitIldifficultairwayoforalandmaxillofacialsurgeryweI℃dividedintofourgroups.TheyweI℃int
5、ubatedbyanewblindtrachealintubationtechnique.Beforeintubation.group1,group2,group3receivedfentanyl4p,g/kgbyintravenousinfusionandpropofolTCI1.Op,g/ml,1.5tLg/ml,2.0p咖l,respectively.Group4onlyreceivedfentanyl4p,g/kg.Allpatientsunderwenttrachealtopicalanesthesia.Theeffectsofanesthesiainthefou
6、rgroupswereobservedandcompared.RESULTS:Ramsayscoreingroup2andgroup3wasobviouslyhigherafteradministerpmpofolTCI(P<0.05).Duringintubation,group2andgroup3kepthigherSCOrethantheothergroups(P<0.05),MAPandHRchangedsmoothlyandsteadilyingroup2andgroup3.ButingroupIandgroup4,MAPandHRincreaseds
7、ignificantly(P<0.05).Duringintubation,RRdecreasedsignificantlyinthefourgroups,butmostseriousingroup3(P<0.05).TherewerenosignificantchangesofSpO2,PⅡc02.Afterintubation,plasmaPRLandplasmaAⅡincreasedobviouslyindifferentdegreesinthefourgroups,theincreaseingr
