不同剂量瑞芬太尼对全麻患者丙泊酚靶控输注诱导剂量及时间的影响  

The effects of different dosages of remifentanil on time and dose with propofol target controlled infusion on general anesthesia patients

作　　者：陆松虹[1] 徐晖[1] 潘松[1] 张景俊[1] 李勇[1] 

机构地区：[1]安徽省蚌埠市第三人民医院麻醉科,233000

出　　处：《蚌埠医学院学报》2012年第3期277-279,共3页Journal of Bengbu Medical College

基　　金：蚌埠市科技计划项目2009-68

摘　　要：目的:观察不同剂量瑞芬太尼持续静脉输注对丙泊酚靶控输注诱导剂量及时间的影响。方法:40例全麻患者随机分为4组,丙泊酚初始靶控输注剂量设为1.5 mg/L,每4 min增加0.5 mg/L,待改良警觉镇静评分(MOAA/S)为1分时,Ⅰ组输注生理盐水,为对照组;Ⅱ、Ⅲ、Ⅳ组持续静脉输注瑞芬太尼,剂量分别为0.1、0.2和0.4μg·kg-1·min-1;在MOAA/S为0分时给予阿曲库铵0.6 mg/kg,3 min后行气管插管。记录瑞芬太尼输注时间及插管时丙泊酚的总量。同时观察诱导期间低血压、心动过缓及呼吸抑制等不良反应。结果:Ⅰ组丙泊酚用量均高于Ⅱ组、Ⅲ组和Ⅳ组(P<0.05～P<0.01),Ⅱ组用量高于Ⅲ组和Ⅳ组(P<0.01和P<0.05),Ⅲ组和Ⅳ组用量差异无统计学意义(P>0.05);Ⅰ组瑞芬太尼输注时间与Ⅱ组差异无统计学意义(P>0.05);Ⅰ组与Ⅲ组和Ⅳ组差异均有统计学意义(P<0.01),Ⅱ组与Ⅲ组、Ⅳ组差异亦有统计学意义(P<0.01),Ⅲ组与Ⅳ组差异有统计学意义(P<0.05)。4组不良反应的发生率有统计学意义(P<0.01)。结论:不同剂量瑞芬太尼可以缩短丙泊酚靶控输注麻醉诱导的时间,减少丙泊酚用量;丙泊酚靶控输注复合瑞芬太尼0.2μg·kg-1·min-1持续静脉输注即可满足临床需求。Objective：To investigate the effects of different dosages of remifentanil on dose and time in propofol target controlled infusion（TCI） induction.Methods：Forty patients,classified as ASAⅠ-Ⅱ,undergoing general anesthesia were randomly divided into four groups：group Ⅰ,group Ⅱ,group Ⅲ and group Ⅳ.Anesthesia was induced with propofol target controlled infusion,the target plasma concentration of propofol was started with 1.5 mg/L,and increased 0.5 mg/L every four minutes.When patients lose response,the patients received remifentanil infusion,the dosage was set at 0.1,0.2,and 0.4 μg·kg-1·min-1 in group Ⅱ,group Ⅲ and group Ⅳ,respectively.The group Ⅰ as a controll received normal saline.When modified obsever is assessment of alertness/sedation scale is zero,0.6 mg/kg tracrium was given to facilitated tracheal intubation after 3 min.The infusion time of remifentanil and total dose of propofol were recorded.The adverse effects such as hypotension,bradycardia and respiratory depression were recorded during induction.Results：The propofol dosages in group Ⅰ were higher than those in group Ⅱ,group Ⅲ and group Ⅳ（P〈0.05-P〈0.01）.The propofol dosages in groupⅡ were higher than those in group Ⅲ and group Ⅳ（P〈0.01 and P〈0.05）;There was no significant difference between groupⅢ and group Ⅳ（P〉0.05）.The infusion time of groupⅠ was not significant different with group Ⅱ（P〉0.05）,but there were significant differences with group Ⅲ and group Ⅳ（P〈0.01）.In contrast to Group Ⅱ,there were differences with group Ⅲ and group Ⅳ（P〈0.01）;and differences between group Ⅲ and group Ⅳ（P〈0.05）.The accidence of adverse effects had significant differences（P〈0.01）.Conclusions：Different doses of remifentanil can reduce the infusion time of propofol TCI,reduce the dose of propofol;propofol TCI induction combined with 0.2 μg·kg-1·min-1 remifentanil infusion can meet the clinical needs.

关 键 词：瑞芬太尼 丙泊酚 靶控输注 持续输注 

分 类 号：R614[医药卫生—麻醉学]