瑞芬太尼靶控输注对乌拉地尔控制性降压效应影响的研究  

Study of the effect of remifentanil with targeted controlled infusion (TCI) on urapidil hydrochloride to influence controlled hypotension

作　　者：刘伟[1] 董业美[2] 臧兴华 邓燕[1] 王开祥[1] 

机构地区：[1]山东省滕州市中心人民医院麻醉科,277500 [2]山东省滕州市中心人民医院手术室,277500 [3]滕州市中医医院麻醉科

出　　处：《中国实用医刊》2010年第8期6-8,共3页Chinese Journal of Practical Medicine

基　　金：滕州市科学技术发展计划内项目（2009053）

摘　　要：目的 观察瑞芬太尼靶控输注(TCI)对乌拉地尔控制性降压效应的影响,探讨两药复合应用的可行性,为控制性降压合理用药提供参考.方法 选择美国麻醉医师协会(ASA)分级Ⅰ～Ⅱ级择期功能性鼻内镜手术(FESS)患者120例,随机分为Ⅰ组(乌拉地尔复合瑞芬太尼组)和Ⅱ组(乌拉地尔组).两组患者麻醉诱导和维持方法相同,平均动脉压(MAP)维持在55～65 mm Hg(1 mm Hg=0.133 kPa),分别记录降压前即刻(T1)及手术开始后5 min(T2)、15 min(T3)、30 min(T4)、60 min(T5)的MAP、血氧饱和度(SpO2)、心率(HR);记录术中尿量、出血量、输液量、输血量;记录降压诱导时间(开始降压至达到目标血压所需时间)、手术时间、拔管时间、乌拉地尔总用量、术野质量评分(SSFQ)以及麻醉结束后的不良反应.结果 Ⅰ组患者降压诱导时间、降压药用量、出血量、手术时间明显低于Ⅱ组(P<0.05);Ⅰ组患者术野质量评分优于Ⅱ组(P<0.05).结论 瑞芬太尼复合乌拉地尔控制性降压,在一定程度上优于单纯乌拉地尔控制性降压.Objective To observe the effect of remifentanil which targeted controlled infusion (TCI) on urapidil hydrochloride to influence controlled hypotension, and approach the feasibility of applying these two drugs, in order to provide rational administration for clinical use. Methods One hundred and twenty American society of anesthesiologists(ASA)Ⅰ-Ⅱand chronic patients who accepted functionality nasal organ endoscopic surgery were randomly divided into two groups as follows: urapidil hydrochloride combined with remifentanil group (groupⅠ) and urapidil hydrochloride group (group Ⅱ). Both groups accepted the same induction and maintenance of anesthesia, and kept mean arterial blood pressure (MAP) about 60-65 mm Hg(1 mm Hg=0.133 kPa). MAP, pulse oxygen saturation (SpO2), heart rate (HR) were recorded before blood pressure (BP) stepped down(T1), after the start of surgery 5 minutes(T2),15 minutes(T3),30 minutes(T4), and 60 minutes(T5). Urinary production, hemorrhage volume, transfusion capacity and blood transfusion volume were recorded during the operation, too. At the same time, time of controlled hypotension induction (the time during BP decreased to prediction), operation persistence, the dot of extubating, the dosage of urapidil hydrochloride, scores of surgical field quality (SSFQ)and adverse effects after operation were recorded.Results The time of controlled hypotension induction, the dosage of urapidil hydrochloride, hemorrhage volume and operation persistence in groupⅠwere significantly lower than that in groupⅡ(P<0.05).Scores of surgical field quality(SSFQ) in groupⅠwere outstripped by group Ⅱ(P<0.05).Conclusions Applied urapidil hydrochloride combining with remifentanil to controlled hypotension surpassed purely used urapidil hydrochloride.

关 键 词：控制性降压 瑞芬太尼 靶控输注 乌拉地尔 

分 类 号：R614[医药卫生—麻醉学]