Guo Zhenggang, Pang Liwei, Jia Xiaopeng, Wang Xiaoyan, Su Xiaojun, Li Ping, Mi Weidong, Hao Jianhua
Department of Anesthesiology, First Affiliated Hospital of General Hospital of PLA, Beijing 100048, China.
Anesthesia and Operation Center, Chinese PLA General Hospital, Beijing 100853, China.
Burns. 2015 Feb;41(1):100-5. doi: 10.1016/j.burns.2014.04.021. Epub 2014 Jun 13.
This study aims to evaluate the feasibility of intraoperative composite target-controlled infusion (TCI) anesthesia application using remifentanil hydrochloride with etomidate in patients with severe burns, as monitored by Narcotrend.
A total of 40 patients with severe burns with eschar excisions and skin grafts were randomly and equally grouped into the etomidate (E) and the propofol groups (P). Anesthesia was induced and maintained by a remifentanil hydrochloride TCI combined with etomidate or propofol. The depth of anesthesia and other relevant indicators were recorded through intraoperative electroencephalogram monitoring using a Narcotrend monitor.
No statistically significant differences were observed between the drug withdrawal times, eye opening requirements, or orientation recoveries of the two groups (P>0.05). The cortisol and aldosterone levels in group E were significantly lower than those in group P 24h post operation (P<0.05). No significant differences between the number of operations, hospitalization duration, mean arterial pressure, heart rate, and postoperative adverse reaction incidence of the two groups were observed at each time point (P>0.05).
The application of a composite remifentanil hydrochloride combined with etomidate TCI is feasible for the early eschar excision in patients with severe burns.
本研究旨在评估在Narcotrend监测下,术中复合靶控输注(TCI)麻醉应用盐酸瑞芬太尼与依托咪酯用于重度烧伤患者的可行性。
40例重度烧伤且需行焦痂切除及植皮手术的患者被随机等分为依托咪酯组(E组)和丙泊酚组(P组)。采用盐酸瑞芬太尼TCI联合依托咪酯或丙泊酚诱导并维持麻醉。术中通过Narcotrend监测仪记录脑电图来监测麻醉深度及其他相关指标。
两组患者停药时间、睁眼需求或定向恢复情况比较,差异均无统计学意义(P>0.05)。术后24小时,E组皮质醇和醛固酮水平显著低于P组(P<0.05)。各时间点两组患者手术次数、住院时间、平均动脉压、心率及术后不良反应发生率比较,差异均无统计学意义(P>0.05)。
盐酸瑞芬太尼复合依托咪酯TCI应用于重度烧伤患者早期焦痂切除手术是可行的。