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The concentration of desflurane preventing spectral entropy change during surgical stimulation: A prospective randomized trial.七氟醚浓度对手术刺激时频谱熵变化的影响：一项前瞻性随机试验。
J Clin Anesth. 2017 Feb;37:86-91. doi: 10.1016/j.jclinane.2016.12.001. Epub 2017 Jan 5.
2
Microcirculation measured by vascular occlusion test during desflurane-remifentanil anesthesia is superior to that in propofol-remifentanil anesthesia in patients undergoing thoracic surgery: subgroup analysis of a prospective randomized study.在接受胸外科手术的患者中，七氟醚-瑞芬太尼麻醉期间通过血管闭塞试验测量的微循环优于丙泊酚-瑞芬太尼麻醉：一项前瞻性随机研究的亚组分析
J Clin Monit Comput. 2017 Oct;31(5):989-997. doi: 10.1007/s10877-016-9937-2. Epub 2016 Sep 26.
3
Considerations for the use of short-acting opioids in general anesthesia.全身麻醉中使用短效阿片类药物的注意事项。
J Clin Anesth. 2014 Feb;26(1 Suppl):S1-7. doi: 10.1016/j.jclinane.2013.11.003. Epub 2014 Jan 29.
4
Anesthesia for off-pump coronary artery bypass surgery.非体外循环冠状动脉搭桥手术的麻醉
Ann Card Anaesth. 2013 Jan-Mar;16(1):28-39. doi: 10.4103/0971-9784.105367.
5
The role of the anesthesiologist in fast-track surgery: from multimodal analgesia to perioperative medical care.麻醉医生在快速康复外科中的作用：从多模式镇痛到围手术期医疗护理。
Anesth Analg. 2007 Jun;104(6):1380-96, table of contents. doi: 10.1213/01.ane.0000263034.96885.e1.
6
Fast-track cardiac anesthesia: efficacy and safety of remifentanil versus sufentanil.快速通道心脏麻醉：瑞芬太尼与舒芬太尼的疗效及安全性比较
J Cardiothorac Vasc Anesth. 2007 Feb;21(1):35-40. doi: 10.1053/j.jvca.2006.03.011. Epub 2006 Jul 24.
7
Comparison of three anesthetic techniques for off-pump coronary artery bypass grafting: general anesthesia, combined general and high thoracic epidural anesthesia, or high thoracic epidural anesthesia alone.非体外循环冠状动脉搭桥术三种麻醉技术的比较：全身麻醉、全身麻醉联合高位胸段硬膜外麻醉或单纯高位胸段硬膜外麻醉。
J Cardiothorac Vasc Anesth. 2005 Feb;19(1):32-9. doi: 10.1053/j.jvca.2004.11.006.
8
Desflurane and remifentanil use during resection of a cardiac pheochromocytoma.心脏嗜铬细胞瘤切除术中地氟醚和瑞芬太尼的应用。
J Cardiothorac Vasc Anesth. 2004 Oct;18(5):630-1. doi: 10.1053/j.jvca.2004.07.015.
9
Desflurane preconditioning induces time-dependent activation of protein kinase C epsilon and extracellular signal-regulated kinase 1 and 2 in the rat heart in vivo.地氟醚预处理可在体内诱导大鼠心脏中蛋白激酶Cε以及细胞外信号调节激酶1和2的时间依赖性激活。
Anesthesiology. 2004 Dec;101(6):1372-80. doi: 10.1097/00000542-200412000-00018.
10
Impact of bispectral index monitoring on stress response and propofol consumption in patients undergoing coronary artery bypass surgery.双谱指数监测对冠状动脉搭桥手术患者应激反应及丙泊酚用量的影响。
Anesthesiology. 2004 Nov;101(5):1096-104. doi: 10.1097/00000542-200411000-00008.

非体外循环冠状动脉手术中的快通道麻醉：正常血压与高血压患者的比较

Fast-Track Anaesthesia in Off-Pump Coronary Surgery: A Comparison of Normotensive and Hypertensive Patients.

作者信息

Öztürk Burçin Melek, Karadeniz Ümit, Bektaş Şerife Gökbulut, Demir Aslı, Çağlı Kerim, Erdemli Özcan

机构信息

Clinic of Anaesthesia, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.

Clinic of Heart Surgery, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.

出版信息

Turk J Anaesthesiol Reanim. 2018 Aug;46(4):276-282. doi: 10.5152/TJAR.2018.70493. Epub 2018 Mar 1.

DOI:10.5152/TJAR.2018.70493
PMID:30140534
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6101717/
Abstract

OBJECTIVE

In this study, our aim was to investigate the efficacy and sufficiency of bispectral indeks (BIS) guided remifentanil-desflurane anaesthesia on intraoperative haemodynamic stability in both normotensive and hypertensive patients undergoing off-pump coronary artery bypass surgery.

METHODS

Thirty adult, ASA I-III patients undergoing elective off-pump coronary surgery were included in the study. According to the presence of essential hypertension preoperatively, patients were divided into two groups. Haemodynamic parameters were recorded at 11 time points during the operation.

RESULTS

There were no differences in the demographic data, heart rate and intraoperative and postoperative parameters between the groups. Arterial blood pressure and additional requirement of remifentanil were found to be significantly higher in the hypertensive group intraoperatively.

CONCLUSION

In patients undergoing off-pump coronary revascularisation surgery, intraoperative haemodynamic stabilisation with remifentanil-desflurane anaesthesia under BIS guidance was safely provided, but higher remifentanil doses were required in hypertensive patients.

摘要

目的

在本研究中，我们的目的是调查在非体外循环冠状动脉搭桥手术中，双谱指数（BIS）引导下瑞芬太尼-地氟烷麻醉对血压正常和高血压患者术中血流动力学稳定性的有效性和充分性。

方法

30例接受择期非体外循环冠状动脉手术的成年ASA I-III级患者纳入本研究。根据术前是否存在原发性高血压，将患者分为两组。在手术期间的11个时间点记录血流动力学参数。

结果

两组之间的人口统计学数据、心率以及术中及术后参数均无差异。术中发现高血压组的动脉血压和瑞芬太尼的额外需求量显著更高。

结论

在接受非体外循环冠状动脉血运重建手术的患者中，在BIS引导下使用瑞芬太尼-地氟烷麻醉可安全地实现术中血流动力学稳定，但高血压患者需要更高剂量的瑞芬太尼。