靶控输注异丙酚复合吸入安氟醚在口腔颌面部手术中的应用.docVIP

靶控输注异丙酚复合吸入安氟醚在口腔颌面部手术中的应用 　　作者：李向京　赵怡芳 刘可斌 　　【关键词】 药物投与系统 　　［摘要］ 目的：研究靶控输注异丙酚复合吸入安氟醚在颌面部手术麻醉中的可行性及推广价值。方法：116例ASA Ⅰ~Ⅱ级口腔颌面部手术病人，随机分为靶控组和恒速组。常规静脉麻醉诱导后行气管内插管，维持期间机械通气，靶控组采用血浆靶控输注技术泵入异丙酚，同时复合吸入1%~2%安氟醚。恒速组采用速率为4~6 mg?kg-1?mL-1输入异丙酚，同时吸入安氟醚。分别在诱导前、插管即刻、插管后5 min、切皮时、缝皮、拔管前、拔管后几个时点记录BP, HR, SPO2 和 ，并与诱导前进行统计学比较；记录入睡时间和苏醒时间，两组间进行比较。结果：与诱导前比较，在插管后5 min SBP、DBP下降明显，MAP则无明显变化，两组相比，入睡时间无明显差异，苏醒时间靶控组明显短于恒速组。结论：靶控输注异丙酚联合应用吸入安氟醚，麻醉效果好，能预测病人的苏醒时间，清醒质量高，是一种经济实用的良好搭配。 　　［关键词］ 药物投与系统 异丙酚 安氟醚 颌面外科手术 　　Application of Target-controlled Propofol Infusion in Combination with Enflurane Inhalation in Oral and Maxillofacial Surgery. 　　LI Xiang-jing, ZHAO Yi-fang, LIU Ke-bin. 　　School of Stomatology， Wuhan University, Wuhan 430079 　　［Abstract］Objective: To investigate the feasibility and potential roles of target-controlled propofol infusion in combination with enflurane inhalation in the oral and maxillofacial surgery. Methods: 116 cases of ASA Ⅰ~Ⅱoral and maxillofacial patients were randomly divided into target-controlled group and control group in this study. After conventional intravenous anesthesia induction, endotracheal intubation was performed and followed by mechanical ventilation in maintenance period. In target-controlled group, anesthesia was maintained by intravenous infusion of propofol and 1%~2% enflurane inhalation. In control group, propofol was intravenously infused with a constant speed of 4~6 mg?kg-1?h-1 in combination with enflurane inhalation. BP, HR, SpO2 and were recorded at different time points, including pre-induction (T1), immediate intubation (T2), 5min after intubation (T3), incision of skin (T4), closure of wound (T5), pre-extubation (T6) and post-extubation (T7). Both falling asleep and awaking times were also recorded in this study. Comparison was made between the results before anesthesia induction and after anesthesia induction, and between those in target-controlled group and those in control group. Results: Compared