瑞芬太尼复合异丙酚靶控静脉麻醉用于地中海贫血患者的临床观察  

Clinical observation of target-controlled infusion of propofol-remifentanil for anesthesia in patients with thalassanemia

作　　者：黄敏 农丕地 

机构地区：[1]佛山市南海区桂城医院麻醉科,广东佛山528200

出　　处：《临床和实验医学杂志》2009年第1期46-48,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的观察瑞芬太尼复合异丙酚靶控静脉麻醉对地中海贫血患者的影响,评价瑞芬太尼复合异丙酚靶控静脉麻醉用于地中海贫血患者的可行性。方法选择40例妇科腹腔镜检查术的病人,分为地中海贫血组(T组,n=20)和对照组(C组,n=20)。设定瑞芬太尼和异丙酚的血浆靶控浓度分别为6ng/ml和3g/ml进行麻醉诱导,术中根据病人反应进行调整。观察给药后意识消失时间、血液动力学变化以及麻醉诱导的平稳性,术中麻醉维持的方便性。记录术毕停药后自主呼吸恢复、睁眼时间和拔除气管导管时间以及术后疼痛评分、瑞芬太尼的用量。结果T组意识消失时间明显短于C组。麻醉诱导期间两组均能引起明显的低血压,T组低血压发生率高于C组,但均未见严重的心血管不良反应。两组术中血液动力学保持较低水平,麻醉维持简便易行。术后自主呼吸恢复时间、睁眼时间和拔除气管导管时间两组差异无显著性,术后疼痛评分和瑞芬太尼总用量差异亦无显著性。结论瑞芬太尼复合异丙酚靶控静脉麻醉可安全地用于地中海贫血患者。Objective This study was designed to observe the effect of anesthesia with target - controlled infusion （TCI） of propofol - remifentanil and evaluate the feasibility of venous anesthesia in patients with thalassanemia. Methods Forty ASA Ⅰ-Ⅱ women patients undergoing gynopathic laparoscopy were divided into two groups： 20 patients with thalassanemia were assigned in group T and 20 patients without thalas-sanemia in group C. Anesthesia was induced with propofol and remifentanil given by TCI. Plasma concentration of propofol was set at 3 g/ml and remifentanil at 6 ng/nd. The time required for loss of consciousness after TCI of propofol - remifentanil, the amount of propofol and remifentanil infused when the patients lost consciousness, changes in mean arterial pressure （MAP） and heart rate （HR） during induction, intubation score, the total amount of pmpofol and remifentanil used were all recorded. At the end of operation, quality of anesthesia was evaluated. Recovery time after anesthesia and postoperative pain score （ VAS score） were also assessed. Results During induction MAP was significantly lower in two groups, and more patients developed hypotension in group T. The incidence of intubation response was lower in group T, but no serious cardiac adverse effects were observed. Transient loss of consciousness （TLOC） was significantly shorter in group T than that in group C. The duration from termination of anesthetics to full recovery of spontaneous breathing, eye opening at request and tracheal extubation, the total amount of remifentanil used and VAS score were similar among the two groups. Conclusion Anesthesia with propofol - remifentanil by TCI is safe and effective in patients with thalassanemia.

关 键 词：哌啶类 异丙酚 地中海贫血 药物投与系统 可行性研究 

分 类 号：R614[医药卫生—麻醉学]