帕瑞昔布钠辅助异丙酚对脑血管造影静脉麻醉效果的临床观察  

Clinical observation of anesthetic effect of parecoxib-assisted propofol on the patients with cerebrovascular disease during DSA period

作　　者：阮剑辉[1] 甘国胜[1] 张燕辉[1] 王庆利[1] 胡明[1] 唐京华[1] 李军明[1] 

机构地区：[1]广州军区武汉总医院麻醉科,武汉430070

出　　处：《中国临床神经外科杂志》2011年第11期650-652,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨帕瑞昔布钠辅助异丙酚对脑血管造影者的麻醉效果及安全性。方法选择120例美国麻醉医师协会分级Ⅰ～Ⅱ级的患者行脑血管造影术。这些患者分为A、B两组,每组60例,其中A组术前15～20min静脉注射帕瑞昔布钠40mg,B组术前静脉注射等量生理盐水。两组患者术中皆用微量泵静脉输注异丙酚维持。记录麻醉前(T1)、股动脉穿刺置管时(T2)、检查开始后20min时(T3)的心率、平均动脉压(MAP)、外周血氧饱和度(SpO2)和呼吸频率及从停药到苏醒的时间;计算单位体重所用的异丙酚量;比较身体舒适度评分(BCS)及术前术后凝血功能。结果两组各时间点MAP、SpO2、心率和呼吸频率均无显著差异(P>0.05);与A组比较,B组BCS评分明显降低、苏醒时间明显延长,且异丙酚用量明显增多(P<0.05);两组患者的凝血功能无显著差异(P>0.05)。结论帕瑞昔布钠用于脑血管造影麻醉能减少异丙酚用量,改善患者舒适度,同时不影响出凝血功能。Objective To observe the anesthetic effect of parecoxib-assisted propofol on the patients with cerebrovascular diseased uring DSA period and its safety.Methods One hundred and twenty cerebrovascular disease patients with ASA gradeⅠ～Ⅱ（age range,1 7～65 years） were divided into group A and group B.In the patients of group A parecoxib sodium 40 mg were intravenously injected andi n the patients of group B the equal volume of physiological saline were intravenously injected 15～20 min before the cerebrala ngiography.Anesthesia was maintained with a continuous infusion of propofol in the patients of both the groups during DSA period.H eart rate（HR） ,mean arterial pressure（MAP） ,SpO 2 and respiratory rate（RR） were recorded before anesthesia（T 1） ,when the femorala rtery being punctured（T 2） ,and 20 min after the beginning of the angiography（T 3） ,and the time from stopping infusion of propofol top atients’revival（T） was observed.The propofol dose per kilogram of body weight was calculated.The Bruggmann comfort scale（BCS） a fter DSA and coagulation function before and after DSA were determined and compared between both the groups.Results BCS score ing roup B was significantly lower than in group A（P0.05） .T was significantly longer and the dose of propofol was significantly higher ing roup B than those in group A.There were insignificant differences in HR,MAP,SpO 2 and RR at T 1,T 2 and T 3 and coagulation functionb etween the two groups.Conclusion Parecoxib sodium can reduce the dose of propofol,increase BCS score and does not affect thec oagulation function in the patients undergoing cerebral angiography.

关 键 词：瑞昔布钠 静脉麻醉 脑血管造影 

分 类 号：R815[医药卫生—放射医学] R971.2[医药卫生—临床医学]