氟马西尼对异丙酚麻醉术后催醒效果的探讨  

The reverse-effect after the anesthesia of Flumazenil on Propofol

作　　者：潘宁[1] 于环[1] 张钰[1] 邵彦[1] 

机构地区：[1]大连医科大学附属二院麻醉科,辽宁大连116027

出　　处：《中国医药导报》2012年第2期101-103,共3页China Medical Herald

摘　　要：目的探讨异丙酚静脉麻醉后应用氟马西尼的催醒效果和脑电双频指数值的变化及是否可以缩短苏醒和拔管时间。方法采用随机双盲对照法,选行甲状腺择期手术患者60例,年龄30～60岁,ASAⅠ～Ⅱ级。将患者随机分为氟马西尼组(F组)和生理盐水组(N组),各30例,采用咪达唑仑、芬太尼、依托咪酯、顺苯磺酸阿曲库铵复合诱导。术中使用异丙酚和瑞芬太尼复合维持,使BIS值维持在(50±5)之间。待手术伤口皮肤缝合结束后停止泵入异丙酚和瑞芬太尼,之后给予实验用药。F组给予5 mL氟马西尼(0.5 mg),N组给予等体积生理盐水,分别记录给药前(T0)及给药后1 min(T1)、2 min(T2)、3 min(T3)、4 min(T4)、5 min(T5)、10 min(T6)、15 min(T7)后的心率、血压、脉搏血氧饱和度、脑电双频指数,记录用药后清醒时间和拔管时间及术后恶心、呕吐等不良反应。结果两组患者的一般状况比较,差异无统计学意义(P>0.05)。N组和F组从停药到清醒和拔管时间及各个时间点的脑电双频指数值变化差异均无统计学意义(均P>0.05)。结论异丙酚静脉麻醉后给予氟马西尼0.5 mg,未发现其能缩短苏醒及拔管时间,也未发现其对BIS值变化有明显影响。Objective To discuss the reverse-effect of the anesthesia of Flumazenil on Propofol and the effects on the number changes of BIS,and to explore if it can shorten the time from anesthesia to awakening and extubation.Methods A random double-blind method was used on 60 patients,who were scheduled for elective thyroid operation,aged 30-60,ASA grade Ⅰ-Ⅱ.The patients were randomly divided into Flumazenil group（group F,30 cases） and normal saline group（group N,30 cases）.Midazolam,Fentanyl,Etomidate and cis-Atracurium were all used during the operation.Propofol and Remifentanil were used intraoperatively in order to maintain a stable number of BIS at（50±5）.Propofol and Remifentanil were stopped being injected after the skin incision was sutrued.And then the experimental potion was given to the patients.5 mL Flumazenil（0.5 mg） was given to the group F while 5 mL normal saline was given to the group N.The heart hate,blood pressure,pulse oximetry and bispecttral index of each patient were recorded at multiple timepoints,before（T0） and after the administration of 1 min（T1）,2 min（T2）,3 min（T3）,4 min（T4）,5 min（T5）,10 min（T6）,15 min（T7） respectively.Meanwhile,the awakening time and extubation time were recorded after the operation.Postoperative nausea and vomiting and other adverse reactions were recorded as well.Results There was no obvious change in general anesthesia of the two groups（P〈0.05）.There was no significant difference on the time from stopping anesthesia to awakening and extubation,the change of BIS at different time between the two groups（all P〈0.05）.Conclusion This method of the anesthesia of 0.5 mg Flumazenil on Propofol can not shorten the time from anesthesia to awakening and extubation obviously.And there is no obvious change of the number of BIS.

关 键 词：氟马西尼 静脉麻醉药 异丙酚 脑电双频指数 

分 类 号：R614.2[医药卫生—麻醉学]