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1、羅呱卡因硬膜外阻滯后異丙酚靶控輸注麻醉臨床觀察【摘要】目的通過腦電雙頻指數(shù)的監(jiān)測,評價羅呱卡因硬膜外用藥后對異丙酚靶控輸注(TCI)時麻醉劑量和質(zhì)量的影響。方法60例接受上腹部手術(shù)患者隨機分為硬膜外羅呱卡因組(GR)和單純異丙酚組(PR)二組。GR組硬膜外給藥20min后,二組TCI輸注異丙酚致意識消失,記錄所需時間,繼續(xù)全麻誘導觀察插管反應。所有患者同時監(jiān)測心電圖(ECG),血壓(MAP),及腦電雙頻指數(shù)(BIS)并記錄異丙酚的效應室濃度(Ce)及用量。結(jié)果患者意識消失所需時間及異丙酚的效應室濃度、用量GR組與PR組有統(tǒng)計學顯著差異。GR組MAP在硬膜外用藥15min、意
2、識消失時、插管后1min,與PR組相比較有顯著性差異。結(jié)論羅呱卡因硬膜外阻滯可減少異丙酚靶控輸注(TCI)時鎮(zhèn)靜催眠的用量,提高麻醉質(zhì)量,并縮短意識消失所需的時間,并且有助于血流動力學的平穩(wěn),減輕插管反應?！娟P(guān)鍵詞】羅呱卡因;二異丙酚;靶控輸注ClinicalstudyoftrachealintubationgeneralanaesthesiawithtargetcontrolledinfusionofpropofolafterepiduralropivaeaineblockYANGXing,HUANGMan,WANGYuanSheng.5DepartmentofAnest
3、hesia,JiangmenCentralHospital,Jiangmen529070,China【Abstract】ObjectiveToevaluatetheeffectoftrachealintubationgeneralanaesthesiawithtargetcontrolledinfusionofpropofolafterepiduralropivaeaineblock.MethodsSixtyASAI～IIpatientsscheduledforupperabdominalsurgerywererandomlyassignedintotwogroups:ro
4、pivaeainegroup,(groupGR,n=30)andpropofolalonegroup,(groupPR,n=30).Twentyminutesafterepidurallocalanestheticsadministration,apropofoltarget-controlledinfusionwasstarteduntiloneminuteaftertrachealintubation.Theconsumedtimeofpatientslosingconsciousness,thetargetconcentrationandtheconsumedamou
5、ntofpropofol,BISandMAPwereallrecordedinfixedtime.ResultsTheconsumedtimeoflosingconseiousness,thetargetconeentrationandtheconsumedamountofpropofolandMAPwereallstatisticallysignificantdifferencebetweentheGRgroupandPRgroup.GRgroupofMAPintheepiduralmedication20minutes,consciousnessdisappears,1
6、5minuteafterintubation,comparedwiththePRgroupweresignificantlydifferent.ConclusionEpiduralropivacaineblockcanenhancethesedativeandhypnoticeffectofpropofoltarget-controlledinfusion,andepiduralropivacaineblockcanimprovethequalityofanesthesia,Andcontributetothesmoothhemodynamic,reducetheintub
7、ationresponse.【Keywords】Ropivacaine;Propofol;Target-controlledinfusion作者單位:529070廣東省江門市中心醫(yī)院麻醉科有研究表明[1]利多卡因硬膜外給藥具有強化全身麻醉藥的鎮(zhèn)靜催眠作用,羅呱卡因是否存在相似的效應,目前尚未有相關(guān)的報道。本研究擬通過腦電雙頻指數(shù)(BIS)的監(jiān)測,評價羅呱卡因硬膜外用藥后對異丙酚靶控輸注(TCI)時麻醉劑量和質(zhì)量的影響。1資料與方法1.1一般資料病例選擇60例膽總管切開取石、膽囊切除的患者,其中男31例,女29例,年
