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不同剂量靶控输注舒芬太尼联合一氧化氮吸入对血流动力学及术后恢复的影响

[Effect of target-controlled infusion sufentanil in different doses combined with nitrogen monoxide inhalation on hemodynamics and postoperative recovery].

作者信息

Yang Xue-Yuan, Xu Xing, Wu Xin-Min

机构信息

Department of Anesthesiology, First Hospital of Peking University, Beijing 100034, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2007 Dec 18;87(47):3325-8.

PMID:18478944
Abstract

OBJECTIVE

To investigate the effect of target-controlled infusion sufentanil in different doses combined with inhalation anesthesia at 0.9 minimum alveolar concentration (MAC) on the intraoperative hemodynamics and postoperative recovery of spontaneous breathing.

METHODS

Sixty patients aged 18-65, weighing 45-80 kg, undergoing colectomy or pedical screw intermix were randomized into 3 groups: Groups S3, S4, and S5 to receive sufentanil at the fixed target plasma concentrations of 0.3, 0.4, and 0.5 ng/ml respectively in combination of nitrogen monoxide inhalation at 0.9 MAC. The arterial blood pressure (ABP), heart rate (HR), electrocardiogram (ECG), and pulse blood oxygen saturation during anesthesia were monitored, the time between the termination of anesthetic use and recovery of spontaneous breathing and extubation were observed, and the use of vasoactive drug and other intravenous anesthetics were recorded.

RESULTS

The BP and HR were nearly stable during the anesthesia in three groups. The values of time from termination of anesthesia to recovery of spontaneous breathing of Groups S2, S3, and S5 were (3.3 +/- 2.0) min, (2.8-2.5) min, and (6.1-3.4) min) respectively without significant differences among them. The time from termination of anesthetic use to extubation of Group S5 was 14.6 +/- 10.9 min, significantly longer than those of Groups S3 and S4: [(9.6 +/- 8.0) and (9.4 +/- 6.4) min, both P < 0.05].

CONCLUSION

When the concentration of inhalation anesthetic is at 0.9 MAC, the target plasma sufentanil concentration of 0.3 ng/ml is adequate in anesthesia. If sufentanil infusion was terminated 50 min before the end of surgery, the patients can recover safely and quickly.

摘要

目的

探讨不同剂量靶控输注舒芬太尼联合0.9倍最低肺泡有效浓度(MAC)吸入麻醉对术中血流动力学及术后自主呼吸恢复的影响。

方法

选取60例年龄18 - 65岁、体重45 - 80 kg行结肠切除术或椎弓根螺钉内固定术的患者,随机分为3组:S3组、S4组和S5组,分别接受靶控血浆浓度为0.3、0.4和0.5 ng/ml的舒芬太尼,联合0.9 MAC的一氧化二氮吸入。监测麻醉期间的动脉血压(ABP)、心率(HR)、心电图(ECG)和脉搏血氧饱和度,观察麻醉结束至自主呼吸恢复及拔管的时间,并记录血管活性药物及其他静脉麻醉药的使用情况。

结果

三组患者麻醉期间血压和心率基本稳定。S2组、S3组和S5组麻醉结束至自主呼吸恢复时间分别为(3.3±2.0)min、(2.8 - 2.5)min和(6.1 - 3.4)min,组间差异无统计学意义。S5组麻醉结束至拔管时间为14.6±10.9 min,显著长于S3组和S4组:[(9.6±8.0)和(9.4±6.4)min,均P < 0.05]。

结论

当吸入麻醉浓度为0.9 MAC时,靶控血浆舒芬太尼浓度为0.3 ng/ml用于麻醉效果良好。若在手术结束前50 min停止输注舒芬太尼,患者可安全、快速恢复。

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