雷米芬太尼复合丙泊酚静脉麻醉的临床应用  

Application of remifentanil combined with propofol infusion in total intravenous anesthesia

作　　者：曾玲双[1] 王学斌[1] 李忠田[1] 高军[1] 陈桂英[1] 杨力群[1] 

机构地区：[1]宁夏医学院第二附属医院麻醉科,银川市750001

出　　处：《临床麻醉学杂志》2005年第4期222-223,共2页Journal of Clinical Anesthesiology

摘　　要：目的观察雷米芬太尼复合丙泊酚静脉麻醉的效果。方法全身麻醉下腰椎手术患者60例,随机均分为雷米芬太尼复合丙泊酚静脉麻醉组(Ⅰ组)和静吸复合麻醉组(Ⅱ组)。雷米芬太尼和丙泊酚的负荷量分别为1μg/kg和1mg/kg,雷米芬太尼以0.5μg·kg-1·min-1速率输注。麻醉中通过增减雷米芬太尼0.1μg·kg-1·min-1输注速率调整麻醉深度。丙泊酚按5∶4∶3方案输注,即5mg·kg-1·h-1输注10min,4mg·kg-1·h-1输注10min,20min后3mg·kg-1·h-1恒速输注。观察两组气管插管反应、麻醉效果、苏醒质量。结果两组麻醉效果相同,均可抑制气管插管反应(P<0.01),且Ⅰ组较Ⅱ组明显(P<0.05)。Ⅰ组苏醒质量较Ⅱ组好(P<0.01),不良反应较Ⅱ组高(P<0.01),术中无知晓。结论雷米芬太尼复合丙泊酚用两个注射泵静脉麻醉,采用负荷量加两种以上速率输注全凭静脉麻醉简便易行。Objective To investigate the effect of remifentanil combined with propofol infusion in the total intravenous anesthesia. Methods Sixty lambar column operation patients under the general anesthesia were randomly divided into two groups.The patients in study group received intravenous remifentanil and propofol,and those in control group received fentanyl and enflurane. Anesthesia in both groups was induced with mindazolam 0.03mg/kg,vecuronium 0.1mg/kg,propofol 1mg/kg and remifentanil 1μg/kg or fentanyl 3μg/kg. In study group,a bolus dose of remifentanil 1μg/kg was given, and in a dose of 0.5μg·kg -1 ·min -1 was pumped during operation. Propofol of 1mg/kg was injected, and pumped in a dose of 5mg·kg -1 ·h -1 for first 10min,then decreased to 4mg·kg -1 ·h -1 for 10min and at 3mg·kg -1 ·h -1 then after. Results The anesthesia efficacy of study group was similar to that of control group.A better recovery and less side effects were found in study group than those in control group. Conclusion The remifentanil combined with propofol,using two pump infusion,for the total intravenous anesthesia is simple and easy.

关 键 词：雷米芬太尼 丙泊酚 静脉麻醉 临床应用 

分 类 号：R614[医药卫生—麻醉学]