摘要
目的 观察靶控输注异丙酚全凭静脉麻醉诱导及术中血流动力学变化、术后苏醒时间及相应的效应室浓度 ,以指导临床合理用药 .方法 15例择期行腹腔镜胆囊切除术患者采用靶控输注异丙酚全静脉麻醉 .设定诱导时效应室目标浓度为 4 mg· L- 1 ,复合咪唑安定 2 mg,芬太尼 2 μg· kg- 1 ,维库溴铵 0 .1mg· kg- 1气管插管 ,术中维持异丙酚浓度为 2mg· L- 1 ,记录诱导前、诱导后 2 min、插管即刻、插管后 2min、切皮及气腹时心率 (HR)、收缩压 (SBP)、舒张压 (DBP)、平均动脉压 (MAP)及停药后苏醒时间 ,苏醒时相应的效应室浓度 .结果 插管即刻 HR,SBP,DBP及 MAP均与诱导前比较有显著差异 (P<0 .0 5 ) ,气腹后 DBP,MAP也较诱导前有明显升高 (P<0 .0 5 ) ,平均苏醒时间为 (8.6± 2 .7) min,相应效应室浓度为 (1.4 8± 0 .2 4 ) mg· L- 1 .结论 采用靶控输注异丙酚全凭静脉麻醉诱导时和维持期血流动力学相对较为稳定 。
AIM To observe the hemodynamic changes during induction and maintenance period, the wakening time after operation and the corresponding effect site blood propofol concentration using target controlled infusion (TCI) with propofol for total intravenous anesthesia. METHODS Fif teen patients scheduled for laparascopic cholesystectomy under TCI with propofol for total intravenous anesthesia were studied. Target blood propofol concentration was initially set at 4 mg·L -1 , anesthesia was induced with this propofol concentration and midazolam 2 mg, fentanyl 2 μg·kg -1 , vecuronium 0.1 mg·kg -1 . In order to maintain anesthesia, the blood propofol concentration was set at 2 mg·L -1 . The heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean artery pressure (MAP) before induction, 2 min after induction, at endotracheal intubation, 2 min after intubation, at incision were recorded respectively. The wakening time after stopping propofol infusion and the corresponding blood propofol concentration at effect site were recorded too. RESULTS HR, SBP, DBP and MAP increased significantly after intubation ( P <0.05), DBP and MAP after pneumoperitoneum were higher than those at induction ( P <0.05). The mean wakening time was (8.6± 2.7 ) min, the corresponding effect site blood propofol concentration was (1.48±0.24) mg·L -1 . CONCLUSION Hemodynamics were relatively stable during anesthesia induction and maintenance period when TCI with propofol was used for total intravenous anesthesia, and the patients woke up soon after the operation.
出处
《第四军医大学学报》
北大核心
2002年第15期1398-1400,共3页
Journal of the Fourth Military Medical University
关键词
靶控输注
异丙酚
静脉麻醉
anesthesia, intravenous
target controlled infusion
propofol
