瑞芬太尼与异丙酚混合应用于硬全联合麻醉的临床观察  

Clinic research of remifentanil and propofol mixed application to general-epidural combined anesthesia

作　　者：王学斌[1] 李忠田[1] 高军[1] 

机构地区：[1]宁夏银川市第一人民医院,宁夏银川750001

出　　处：《宁夏医学杂志》2005年第5期317-319,共3页Ningxia Medical Journal

摘　　要：目的　探讨瑞芬太尼(RF)与异丙酚(PP)混合应用的可行性。方法　选择上腹手术行硬全联合麻醉者6 0例。硬膜外阻滞及静脉用药种类相同,按RF和PP给药方式不同,随机分为两组:单泵混用组和双泵并用组。诱导方式和用药量相同;维持:RF -PP双泵组异丙酚TCI定标1.5 μg ml血浆效应室浓度,RF -PP单泵混用组异丙酚按3mg (kg·h)恒速输注,RF皆按0 .10 μg (kg·min)给药。术中不使用肌松剂。用同一标准观察两组副作用、麻醉稳定性及意识恢复质量。结果　单泵混用组与双泵并用组用药总量相近,诱导期、麻醉维持期和停药拔管后各观察指标无明显差异。结论　(1)RF与PP混合不降低疗效,不增加副作用;(2 )RF2 0 μg ml的浓度适宜硬全联合麻醉用药,可以达到催眠镇痛的最适有效剂量;(3)恒速输注可以满足手术要求。Objective To examine the feasibility of mixed application of propofol(PP) and remifentanil(RF).Methods Chose 60 cases of upper abdomen operations under general-epidural combined anesthesia. The mode of epidural block and anesthetic of intravenation in all cases were alike. These cases were divided into two groups according to the difference of infusion ways: single bump group(groupⅠ) and double bump group(groupⅡ). The anesthetic and the pattern of induction were identical. Maintenance: in groupⅠ, effective compartment concentration of PP was fixed at 1.5 μg/ml with TCI bump, in contradistinction, PP was infused at a permanent speed of 3 mg/(kg·h) in groupⅡ.RF was infused at the same speed of 0.10 μg/(kg·min) in both groups. No relaxant was applied during operation. The side effect, anesthesia stability and revival degree were compared with same standard.Results The total dose of anesthetic applied to both groups was close,and there was no difference in every observed index of induction, anesthesia maintenance and after removing intratracheal tube.Conclusion (1)That mix RF with PP would not reduce curative effect or increase side reaction.(2)RF's concentration of 20μg/ml is suitable for general-epidural combined anesthesia, can be used for hypnogenesis and analgesia.(3)Infusion at a permanent rate can meet the need of operation.

关 键 词：瑞芬太尼 异丙酚 混合应用 

分 类 号：R614[医药卫生—麻醉学]