瑞芬太尼联合丙泊酚全凭静脉麻醉抑制气管拔管期循环反应的最低有效浓度  

Minimum effective concentration of remifentanil and propofol total intravenous anesthesia in inhibition of circulating response during tracheal extubation

作　　者：黄进强[1] 程俭[1] 陆光泽[1] 李宁清[1] 

机构地区：[1]广东省高州市人民医院麻醉科一区,525200

出　　处：《中国实用医刊》2017年第9期78-80,共3页Chinese Journal of Practical Medicine

摘　　要：目的 探讨瑞芬太尼联合丙泊酚全凭静脉麻醉抑制气管拔管期循环反应的最低有效浓度.方法 选取2015年1月至2016年6月行全身麻醉手术患者180例,均行瑞芬太尼联合丙泊酚全凭静脉麻醉,并根据上下序贯原则,对瑞芬太尼的浓度予以调整,比较不同时间点患者的心率（HR）、平均动脉压（MAP）和脑电双频指数（BIS）的变化.结果 麻醉诱导中,患者的HR、MAP和BIS在气管插管前最低,明显低于其他时间段（P〈0.05）;BIS在气管插管前后比较差异未见统计学意义（P〉0.05）.术后VAS评分为（1.8±0.3）分,无恶心呕吐等不良反应.抑制循环反应的半数有效血浆靶浓度为1.56 ng/ml,95%CI为1.44-1.70 mg/ml.结论 丙泊酚浓度维持在3 μg/ml时,抑制气管拔管期循环反应的瑞芬太尼最低有效浓度为1.56 ng/ml.Objective To investigate the effect of remifentanil and propofol total intravenous anesthesia on the minimum effective concentration in the inhibition of tracheal extubation.Methods A total of 180 patients with general anesthesia surgery from January 2015 to June 2016 were selected, and all of them were given remifentanil and propofol total intravenous anesthesia, concentration of remifentanil was adjusted according to the principle of sequential, the change of different time in patients with HR, MAP and BIS indexes was compared.Results During the induction of anesthesia, HR, MAP of the patients were the lowest before tracheal intubation, which were lower than those in other time periods（P〈0.05）;BIS had no significant difference before and after tracheal intubation （P〉0.05）.Postoperative VAS score was 1.8±0.3, and no adverse reactions such as nausea and vomiting occured.After calculation, the inhibition of cyclic reaction of EC50 was 1.56 ng/ml, 95%CI was 1.44-1.70 mg/ml.Conclusions When the concentration of propofol is maintained at 3 μg/ml, the minimum effective concentration of remifentanil in inhibiting tracheal extubation is 1.56 ng/ml.

关 键 词：瑞芬太尼 丙泊酚 全凭静脉麻醉 气管拔管期 循环反应 有效浓度 

分 类 号：R614[医药卫生—麻醉学]