摘要
目的探讨艾司洛尔或尼卡地平联合诱导期容量填充对全凭静脉麻醉丙泊酚用量的影响。方法择期行脊柱手术的患者36例,随机均分为三组:艾司洛尔组(E组)于诱导前2min静注艾司洛尔1mg/kg,继之以100μg·kg-1·min-1微量泵输注至术毕;尼卡地平组(N组)于诱导前2min静注尼卡地平10μg/kg,继之以1μg·kg-1·min-1微量泵输注至术毕;生理盐水组(C组)于相同时间点给予等量生理盐水。三组患者均于给予血管活性药物开始20min内快速静滴羟乙基淀粉130/0.410ml/kg行容量填充。麻醉诱导和维持均采用TCI丙泊酚和舒芬太尼,调节丙泊酚效应室浓度使术中BIS值维持在40～60。记录丙泊酚用量,清醒和拔管时间。结果与C组比较,E组和N组丙泊酚用量显著减少(P<0.05),清醒和拔管时间明显缩短(P<0.05)。结论艾司洛尔或尼卡地平联合诱导期容量填充不仅有利于维持血流动力学的平稳,而且能够明显减少全凭静脉麻醉丙泊酚用量,缩短清醒和拔管时间。
Objective To investigate effects of esmolol or nicardipine combined with volume expansion on propofol dosage during induction of total intravenous anesthesia. Methods Thirty six patients scheduled for elective spinal surgery were equally randomized into 3 groups. In group E, 1 mg/kg esmolol was injected 2 min before induction and maintained with 100/,g. kg-I ~ min-1. Group N received 10/~g/kg nicardipine followed by infusion of 1μg-kg-1 .min-1 , while group C received the same volume of saline. All patients were expanded with 10 ml/kg hydroxyethyl starch （HES 130/ 0. 4） 20 rain after the beginning of drug treatment. Anesthesia was maintained with target-controlled infusion（TCI） of propofol and sufentanil. Bispetral index （BIS） was controlled between 40 60. The consumption of propofol, recovery of consciousness and trachea extubation were recorded. Results Compared with group C, the consumption of propofol was lower and the time of consciousness recovery and extubation was significantly shorter in group E and group N （P〈0.05）. Conclusion Esmolol or nicardipine combined with volume expansion during induction could reduce cardiovascular response, decrease propofol consumption and shorten the time of consciousness recovery and extubation in total intravenous anesthesia.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2012年第12期1178-1180,共3页
Journal of Clinical Anesthesiology
