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异氟烷麻醉与全静脉麻醉对麻醉期间体温降低程度及术后寒战发生率影响的比较

Comparison of the effects of anesthesia with isoflurane and total intravenous anesthesia on the intensity of body temperature reduction during anesthesia and incidence of postoperative chills.

作者信息

Khan Zahid Hussain, Arab Saghar, Emami Behruz

机构信息

Department of Anesthesiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Iran.

出版信息

Acta Med Iran. 2011;49(7):425-32.

Abstract

This study compared the effects of anesthesia with isoflurane and TIVA (total intravenous anesthesia) on the intensity of body temperature reduction during anesthesia and incidence of chills after lumbar disc surgery. The study was done as a single blinded randomized clinical trial. From 60 patients who underwent lumbar disc surgery, 30 subjects were placed in isoflurane group and 30 in the TIVA group. Maintenance of anesthesia was done with isoflurane (MAC=0.8-1) and N(2)O 50% in isoflurane group and in TIVA group with propofol at the dose of 100-150 mg /kg body weight /minute and remifentanil at the dose of 2.0 mg /kg body weight/minute. Chills rate was recorded in recovery room. Changes in body temperature, body surface temperature, systolic blood pressure, diastolic blood pressure and heart rate showed no significant difference between the two groups before and after induction and at different times during the operation (P<0.05). Chill rate was not significantly different between the two groups (P<0.05). It seems that TIVA (remifentanil at the dose of 2.0 µg/kg body weight/minute in combination with propofol at the dose of 100-150 µg/kg body weight/minute) and 0.81 MAC isoflurane-N(2)O 50% can be used as a safe method of anesthesia in patients with good tolerance lumbar back disc surgery without hypothermia, chills and considerable hemodynamic changes.

摘要

本研究比较了异氟烷麻醉和全凭静脉麻醉(TIVA)对腰椎间盘手术后麻醉期间体温降低强度及寒战发生率的影响。该研究作为一项单盲随机临床试验进行。从60例行腰椎间盘手术的患者中,30名受试者被纳入异氟烷组,30名被纳入TIVA组。异氟烷组通过异氟烷(MAC = 0.8 - 1)和50%氧化亚氮维持麻醉,TIVA组则使用剂量为100 - 150毫克/千克体重/分钟的丙泊酚和剂量为2.0微克/千克体重/分钟的瑞芬太尼维持麻醉。在恢复室记录寒战发生率。两组在诱导前、诱导后及手术期间不同时间的体温、体表温度、收缩压、舒张压和心率变化均无显著差异(P < 0.05)。两组的寒战发生率也无显著差异(P < 0.05)。似乎TIVA(剂量为2.0微克/千克体重/分钟的瑞芬太尼与剂量为100 - 150微克/千克体重/分钟的丙泊酚联合使用)和0.81 MAC异氟烷 - 50%氧化亚氮可作为一种安全的麻醉方法,用于对腰椎间盘手术耐受性良好、无体温过低、寒战及明显血流动力学变化的患者。

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