靶控输注异丙酚全凭静脉麻醉_医学论文.docVIP

靶控输注异丙酚全凭静脉麻醉_医学论文 靶控输注异丙酚全凭静脉麻醉_医学论文 作者：柴 伟，于代华，高昌俊，杨永慧，孙绪德 【关键词】 麻醉 关键词: 麻醉，静脉内靶控输注异丙酚 摘 要:目的 观察靶控输注异丙酚全凭静脉麻醉诱导及术中血流动力学变化、术后苏醒时间及相应的效应室浓度，以指导临床合理用药. 方法 15例择期行腹腔镜胆囊切除术患者采用靶控输注异丙酚全静脉麻醉.设定诱导时效应室目标浓度为4mg#12539L-1 ，复合咪唑安定2mg，芬太尼2μg#12539kg-1 ，维库溴铵0.1mg#12539kg-1 气管插管，术中维持异丙酚浓度为2mg#12539L-1 ，记录诱导前、诱导后2min、插管即刻、插管后2min、切皮及气腹时心率（HR）、收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）及停药后苏醒时间，苏醒时相应的效应室浓度. 结果 插管即刻HR，SBP，DBP及MAP均与诱导前比较有显著差异（0.05），气腹后DBP，MAP也较诱导前有明显升高（0.05），平均苏醒时间为（8.6±2.7）min，相应效应室浓度为（1.48±0.24）mg#12539L-1 . 结论 采用靶控输注异丙酚全凭静脉麻醉诱导时和维持期血流动力学相对较为稳定，术后苏醒较为迅速. 　　Keywords:anesthesia，intravenoustarget-controlled infu-sionpropofol 　　Abstract:AIM To observe the hemodynamic changes dur-ing induction and maintenance period，the wakening time af-ter operation and the corresponding effect site blood propofol concentration using target-controlled infusion（TCI）with propofol for total intravenous anesthesia.METHODS Fif-teen patients scheduled for laparascopic cholesystectomy un-der TCI with propofol for total intravenous anesthesia were studied.Target blood propofol concentration was initially set at4mg#12539L-1 ，anesthesia was induced with this propofol con-centration and midazolam2mg，fentanyl2μg#12539kg-1 ，ve-curonium0.1mg#12539kg-1 .In order to maintain anesthesia，the blood propofol concentration was set at2mg#12539L-1 .The heart rate（HR），systolic blood pressure（SBP），diastolic blood pressure（DBP），mean artery pressure（MAP）before induction，2min after induction，at endotracheal intubation，2min after intubation，at incision were recorded respectively.The wakening time after stopping propofol infusion and the corresponding blood propofol concentration at effect site were recorded too.RESULTS HR，SBP，DBP and MAP in-creased significantly after intubation（0.05），DBP and MAP after pneumoperitoneum were higher than those at in-duction（0.05）.The mean wakening time was（8.6±2.7）min，the corresponding effect site blood propofol concentration was（1.48±0.24）mg#12539L-1 .CONCLUSION Hemodynamics were relativ