丙泊酚-雷米芬太尼靶控输注在心脏手术中的应用  

Target-controlled infusion of propofol and remifentanil in patients undergoing cardiac surgery

作　　者：林霖[1] 李立环[1] 岳云[2] 于布为[3] 

机构地区：[1]中国医学科学院阜外心血管病医院麻醉科,北京市100037 [2]北京朝阳医院麻醉科 [3]上海瑞金医院麻醉科

出　　处：《临床麻醉学杂志》2008年第6期471-472,共2页Journal of Clinical Anesthesiology

摘　　要：目的观察丙泊酚-雷米芬太尼靶控输注(TCI)在心脏瓣膜置换术和冠状动脉旁路移植术中使用的安全性、有效性以及对术后恢复的影响。方法择期心脏手术患者150例,以丙泊酚TCI、雷米芬太尼3～5μg/kg诱导,丙泊酚-雷米芬太尼2～8ng/mlTCI维持,维持脑电双频指数(BIS)于50±10。观察术中血流动力学指标和术后恢复情况。结果所有患者术中血流动力学平稳,术后恢复良好,无术中知晓。结论雷米芬太尼[效应部位浓度(Ce)2～8ng/ml]复合丙泊酚[血浆浓度(Cp)1～2μg/ml]用于心脏手术的麻醉安全有效,血流动力学平稳,有利于术后早期气管拔管。Objective To assess the efficacy and safety of a total intravenous anesthetic technique using propofol and remifentanil target-controlled infusion （TCI） in patients undergoing cardiac surgery. Methods One hundred and fifty patients scheduled for cardiac surgery were included in this study. Anesthesia was induced with propofol TCI,remifentanil 3-5 μg/kg and maintained with propofol and remifentanil （2-8 ng/ml） TCI. Calculated plasma consentration （Cp） of propofol was titrated to keep bispectral index （BIS） values at 50±10. Hemodynamics and recovery variables were recorded. Results All patients remained hemodynamically stable throughout the perioperative period and recovered smoothly. Intraoperative awareness was not noted. Conclusion The combination of remifentanil（Ce 2-8 ng/ml） and propofol （Cp 1-2 μg/ ml） TCI is effective and safe with stable hemodynamics and benefit of early extubation in patients undergoing cardiac anesthesia.

关 键 词：丙泊酚 靶控输注 血流动力学 

分 类 号：R614[医药卫生—麻醉学]