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《依托咪酯復(fù)合不同劑量舒芬太尼在老年顱腦手術(shù)麻醉誘導(dǎo)中的應(yīng)用.pdf》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在行業(yè)資料-天天文庫(kù)。
1、實(shí)用藥物與臨床2014年第17卷第1期PracticalPharmacyAndClinicalRemedies．2014．Vo1．17，No．1·15·依托咪酯復(fù)合不同劑量舒芬太尼在老年顱腦手術(shù)麻醉誘導(dǎo)中的應(yīng)用龍波，吳曉蕾，柴軍，趙平[摘要]目的探討依托咪酯復(fù)合不同劑量舒芬太尼在老年顱腦手術(shù)麻醉誘導(dǎo)中的應(yīng)用。方法擇期顱腦手術(shù)的老年患者60例，年齡60～80歲，根據(jù)誘導(dǎo)時(shí)舒芬太尼的劑量不同分為2組：I組30例。給予舒芬太尼0．3g／kg；Ⅱ組3O例，給予舒芬太尼0．5g／kg。3min后給予依托咪酯0．2me,／kg，入睡后羅庫(kù)溴銨0．8mg／kg行氣管
2、插管。分別記錄患者誘導(dǎo)前(TO)、誘導(dǎo)后(T1)、氣管插管前(T2)、氣管插管即刻(T3)、氣管插管后1min(T4)和氣管插管后5rain(T5)時(shí)刻的MAP、HR、BIS和SpO2。記錄意識(shí)消失時(shí)間和誘導(dǎo)時(shí)間，記錄有無(wú)呼吸抑制、注射痛、肌陣攣和胸壁僵直等不良反應(yīng)。結(jié)果兩組年齡、體重指數(shù)、誘導(dǎo)時(shí)間、意識(shí)消失時(shí)間、各時(shí)點(diǎn)BIS值及SpO2差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0．05)。I組和Ⅱ組的MAP和HR在TO和T1時(shí)點(diǎn)上無(wú)顯著變化，而I組在T3、T4和T5時(shí)點(diǎn)的MAP明顯升高，HR增快，與Ⅱ組比較，差異有統(tǒng)計(jì)學(xué)意義(P<0．05)。Ⅱ組在T2時(shí)點(diǎn)MAP較誘導(dǎo)前
3、明顯降低，但與I組比較，差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0．05)，其余各時(shí)點(diǎn)的血流動(dòng)力學(xué)變化不明顯。結(jié)論舒芬太尼0．5g／kg復(fù)合依托咪酯更適合用于老年顱腦手術(shù)的麻醉誘導(dǎo)。[關(guān)鍵詞]麻醉誘導(dǎo)；神經(jīng)外科；依托咪酯；舒芬太尼Applicationofetomidatewithdiferentdosesofsufentanylforneuroanesthesiain-ductioninelderlypatientsLONGBo，wuXiao．1ei，CHAIJun，ZHAOPing(DepartmentofAnesthesiolo—gY，ShengjingHospi
4、talofChinaMedicalUniversity，Shenyang110004，China)[Abstract]ObjectiveToinvestigatetheappropriatedosagesofsufentanylwithetomidateforneuroanesthesiainductioninelderlypatients．Methods60patientsaged60～80yearswithelectiveneurosurgerywererandomlydivid—edintotwogroupsaccordingtothediffe
5、rentdosesofsufentany1．Group1wasgivensufentanyl0．3LLg／kg．Group11wasgivensufentanyl0．5g／kg．Threeminuteslater，etomidate0．2mg／kgwasgivenintravenously．Ifthepatientsreachedlossofeyelashreflex，rocuronium0．8me,／kgwasgiven．HR，MAP，BIS，SpO2changesofpatientsinthetwogroupswereobservedatdiffe
6、renttimepointsbeforeinduction(TO)，afterinduction(T1)，beforeintubation(T2)，theimmediatelyintubation(T3)，afterintubation1min(T4)and5min(T5)；aswellastheconsciousdisappearancetime，intubationtime．Theadversereactionssuchasrespiratorydepression，injectionpain，myoctonusandchestwallrigidi
7、tywerealsorecorded．ResultsTherewasnoobviousdifferencebetweenthetWOgroupsinage，bodymassindex，induc—tiontime，consciousdisappearancetime，BISvalue．MAPandHRhadnoapparentchangeingroupIandgroupIIatTOandT1．However，ingroupI，HRandMAPatT3，T4andT5pointsincreasedsignificantly，theindexeswereh
8、igh—erthanthoseingroupⅡ(P<0．05)．MAPingroupⅡatT2
