瑞芬太尼复合咪唑安定微泵输注全凭静脉麻醉的临床应用  

作　　者：于明[1] 赵泽宇[1] 

机构地区：[1]四川广元市中心医院麻醉科,628000

出　　处：《中国社区医师（医学专业）》2010年第19期65-66,共2页

摘　　要：目的:观察瑞芬太尼复合咪唑安定微泵输注全凭静脉麻醉的效果。方法:全凭静脉麻醉下随机选择胸椎、腰椎手术(A组)、腹腔镜下胆囊切除手术(B组)和胸科手术(C组)各50例患者,ASAⅠ～Ⅱ级,年龄18～70岁。麻醉维持采用瑞芬太尼(浓度为100μg/ml)以0.2～0.3mg/(kg.小时)速率输注。通过增减瑞芬太尼的输注速率调整麻醉深度,咪唑安定以0.15～0.2mg/(kg.小时)恒速输注。术毕停药。观察并记录从停药至患者呼之睁眼时间、自主呼吸恢复时间、拔管时间、定向力恢复时间。结果:三组患者麻醉与手术时间比较,差异有统计学意义(P<0.05或P<0.01)。从停药至患者呼之睁眼时间、自主呼吸恢复时间、拔管时间、定向力恢复时间差异无统计学意义,P>0.05。结论:瑞芬太尼复合咪唑安定使用微量泵输注全凭静脉麻醉简便易行,安全可靠。Objective：To observation the effects of remifentanil combined with midazolam infusion of micro-pump during total intravenous anesthesia（TIVA）.Methods：150 patients of both sexes,ASA class from Ⅰ to Ⅱ,aged 18～70yr,were randomly allocated into three groups according to the different types of surgery：thoracic spine or lumbar spine surgery group （group A,n=50）,laparoscopic cholecystectomy group （group B,n=50） and thoracic surgery group （group C,n=50）.Anesthesia was maintained with remifentanil （concentration of 100μg/ml） at a rate of 0.2～0.3 mg·kg^-1·h^-1.Increasing or decreasing in remifentanil infusion rate adjust of the depth of anesthesia.Midazolam was infused at a constant rate of 0.15～0.2 mg·kg^-1·h^-1.Anesthetics was stopped pumping at the end of surgery.The patient＇s eyes opening time,self-breathing recovery time,extubation time,and directional power recovery time were assessed after stopping anesthetics.Results：The difference was statistically significant of the anesthesia or operation time of three groups （P〈0.05orP〈0.01）.It was no statistically significant difference which of the patient＇s eyes opening time,self-breathing recovery time,extubation time,and directional power recovery time（P〉0.05）.Conclusion：It was simple,convenient,safe and reliable of remifentanil combined with midazolam infusion of micro-pump during TIVA.

关 键 词：咪唑安定 瑞芬太尼 输注 微泵 全凭静脉麻 

分 类 号：R614.24[医药卫生—麻醉学]