[1]田 道,张盘石,刘艳霞,等.不同剂量瑞芬太尼联合丙泊酚靶控输注对老年全麻患者应激反应和血流动力学的影响研究*[J].陕西医学杂志,2020,49(7):827-829870.[doi:DOI:10.3969/j.issn.10007377.2020.07.016]
　TIAN Dao,ZHANG Panshi,LIU Yanxia,et al.Effects of different doses of remifentanil combined with propofol target-controlled infusion on stress response and hemodynamics in elderly patients with general anesthesia[J].,2020,49(7):827-829870.[doi:DOI:10.3969/j.issn.10007377.2020.07.016]
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不同剂量瑞芬太尼联合丙泊酚靶控输注对老年全麻患者应激反应和血流动力学的影响研究*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年7期
页码:
827-829870
栏目:
临床研究
出版日期:
2020-07-05

文章信息/Info

Title:
Effects of different doses of remifentanil combined with propofol target-controlled infusion on stress response and hemodynamics in elderly patients with general anesthesia
作者:
田 道1; 2; 张盘石2; 刘艳霞2; 冯毅凡3△
1.空军军医大学第一附属医院麻醉科(西安 710032); 2.陕西省荣誉军人康复医院麻醉科(华阴 714200); 3.陕西省宝鸡市人民医院麻醉科(宝鸡 721000)
Author(s):
TIAN Dao; ZHANG Panshi; LIU Yanxia; et al.
Department of Anesthesiology,the First Affiliated Hospital of Air Force Military Medical University(Xi'an 710032)
关键词:
瑞芬太尼;  丙泊酚;  靶控输注;  老年全麻;  应激反应;  血流动力学
Keywords:
Remifentanil;  Propofol;  Target-controlled infusion;  General anesthesia in the elderly;  Stress response;  Hemodynamics
分类号:
R614.2
DOI:
DOI:10.3969/j.issn.10007377.2020.07.016
文献标志码:
A
摘要:
目的:探究不同剂量瑞芬太尼联合丙泊酚靶控输注对老年全麻患者应激反应和血流动力学的影响。方法:纳入全麻手术老年患者180例,按照随机数字法分为A组、B组和C组各60例。三组患者均进行丙泊酚靶控输注,并进行瑞芬太尼的静脉注射,其中A组输注剂量为1.0 μg/kg,B组为2.0 μg/kg,C组为3.0 μg/kg。比较三组患者T0～T3时的血流动力学相关指标,T0、T2和T3时肾上腺素和去甲肾上腺素的水平以及不良反应发生率。结果:B组MAP在T0、T1、T2和T3时,明显高于A组同时间点(P<0.05)。C组在T1、T2和T3时的MAP均明显高于A组同时间点(P<0.05),在T1、T2时的RR明显高于A组同时间点(P<0.05)。与A组相比,B组和C组T2时肾上腺素和去甲肾上腺素水平变化比较差异无统计学意义(P>0.05),T3时肾上腺素和去甲肾上腺素水平均明显降低(P<0.05)。B组呛咳发生率明显低于A组(P<0.05),C组躁动、呛咳发生率均明显低于A组(P<0.05),C组低血压、心动过缓发生率均明显高于A组(P<0.05)。结论:瑞芬太尼剂量为2.0 μg/kg时,联合丙泊酚靶控输注更易维持老年全麻患者血流动力学的稳定,降低气管插管引起的应激反应,且安全性好。
Abstract:
Objective:To study the effects of different doses of remifentanil combined with propofol target-controlled infusion on stress response and hemodynamics in elderly patients with general anesthesia. Methods:180 elderly patients were divided into group A,group B and group C according to the random number method,with 60 cases in each group. Target-controlled infusion of propofol and intravenous remifentanil were administered to all three groups of patients. The infusion dose was 1.0 μg/kg in group A,2.0 μg/kg in group B,and 3.0 μg/kg in group C. The hemodynamic related indexes at T0-T3,the levels of epinephrine and norepinephrine at T0,T2,and T3,and the incidence of adverse reactions were compared. Results:The MAP of group B at T0,T1,T2 and T3 was significantly higher than that of group A at the same time point(P <0.05). The MAP of group C at T1,T2 and T3 was significantly higher than that of group A at the same time point(P<0.05),and the RR at T1 and T2 was significantly higher than that of group A at the same time point(P<0.05). Compared with group A,there was no significant difference in the levels of epinephrine and norepinephrine at T2 between group B and C(P>0.05),and the levels of epinephrine and norepinephrine at T3 were significantly lower(P<0.05). The incidence of choking in group B was significantly lower than that in group A(P<0.05). The incidence of agitation and choking in group C were significantly lower than those in group A(P<0.05). The incidence of hypotension and bradycardia in group C were significantly higher than those in group A(P<0.05). Conclusion:When the remifentanil dose is 2.0 μg/kg,target-controlled infusion of propofol is easier to maintain hemodynamic stability,reduce the stress response caused by tracheal intubation,and has good safety.

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备注/Memo

备注/Memo:
*陕西省自然科学基金资助项目(2016JQ2341)
更新日期/Last Update: 2020-07-28