三种不同剂量瑞芬太尼复合丙泊酚麻醉对气腹时心血管反应的影响(1)
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[摘要] 目的 研究三种不同浓度瑞芬太尼复合丙泊酚麻醉对气腹时血流动力学的影响。方法 将本院2010年3月～2011年5月收治的75例行腹腔镜手术的患者随机分成3组，每组25例，Ⅰ、Ⅱ、Ⅲ组瑞芬太尼剂量为2、4、6 ng/mL；每组复合丙泊酚剂量均为2 μg/mL。采用静脉注射麻醉，记录插管前10 min(T1)和建立气腹前(T2)、后5 min(T3)，患者的心率(HR)、血压(BP)和平均动脉压(MAP)的变化。 结果 3组患者T1的基础值差异无统计学意义(P > 0.05)；T2时3组患者HR和MAP较T1均下降，Ⅰ组MAP下降更明显，Ⅲ组HR下降更明显，差异有统计学意义(P < 0.05)；T3时3组患者HR和MAP较T2均上升，Ⅰ组MAP上升更明显，Ⅲ组HR上升更明显，差异有统计学意义(P < 0.05)。 结论 瑞芬太尼剂量为4、6 ng/mL时，比2 ng/mL可以明显地减弱气腹时心血管反应。
[关键词] 瑞芬太尼；丙泊酚；气腹；血流动力学
[中图分类号] R614 [文献标识码] A [文章编号] 1674-4721(2012)02(b)-0090-02
The effect of three different doses of remifentanil and propofol anesthesia on cardiovascular response in pneumoperitoneum
QU Bo
Qidong People′s Hospital of Hunan Province, Qidong 421600, China
[Abstract] Objective To study the three different concentration rachel fentanyl compound poisson phenol of clinical anesthesia when hemodynamic effects. Methods Seventy five routine laparoscopic surgery patients were randomly divided into three groups from March 2010 to May 2011, each group of 25 cases, Ⅰ, Ⅱ, Ⅲ group red fentanyl dose of 2, 4, 6 ng/mL; Each group of compound poisson phenol doses were 2 μg/mL. The intravenous anesthesia, record before intubation 10 minutes (T1) and establish gasless laparoscopic (T2), before and after five minutes (T3), patients with heart rate (HR), blood pressure (BP) and mean arterial pressure (MAP) change. Results The three groups of patients, the foundation of the value differences in T1 was no significant (P > 0.05); Three groups of patients when HR and MAP decreased in T2 than these in T1, Ⅰ group dropped significantly more MAP, Ⅲ group HR down more apparent, the difference was statistically significant (P < 0.05); 3 group patients HR and MAP were rising in T3 than these in T2, Ⅰ group rose significantly more MAP, Ⅲ group HR rise more apparent, the difference was statistically significant (P < 0.05). Conclusion Rachel fentanyl dose for 4, 6 ng/mL, than 2 ng/mL can significantly reduce cardiovascular reaction when pneumoperitoneum.
[Key words] Remifentanil; Propofol; Pneumoperitoneum; Cardiovascular response ......
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