摘要
目的监测不同血浆药物浓度的地佐辛应用在冠状动脉旁路移植手术麻醉初期不同时刻血流动力学的指标变化,探讨合理用药。方法选取80例无肝肾功能障碍的冠状动脉旁路移植手术患者,随机分成4组(Ⅰ、Ⅱ、Ⅲ、Ⅳ组),均常规使用咪达唑仑、依托咪酯和维库溴铵麻醉诱导和肌肉松弛;同时使用靶控输注技术(TCI)分别设定4组以10、20、30、40ng/mL的血浆药物浓度输注地佐辛注射液,记录麻醉诱导前1min(T1)、BIS值降到65时(T2)、即行气管插管前(T3)、气管插管后20s(T4)、切皮后20s(T5)和锯胸骨后20s(T6)各个时间点的血流动力学指标,利用统计软件比较各组间、组内的血流动力学指标变化差异度。结果气管插管后20s(T4)、切皮后20s(T5)和锯胸骨后20s(T6)各个时间点的SP、DP、HR与气管插管前(T3)相比,Ⅰ、Ⅱ组明显高于Ⅲ、Ⅳ组;Ⅲ、Ⅳ组间差异无统计学意义。结论地佐辛血浆药物浓度达到30ng/mL以上,可以满足冠状动脉旁路移植手术麻醉初始阶段的镇痛要求。
Objective To monitoring hemodynamic indexes of different plasma drug concentration of dezocine used in CABG operation anesthesia early in different time,to explore the rational use of drugs.Methods Eighty patients without liver and kidney dysfunction in patients with CABG operation were randomly divided into four groups （Ⅰ,Ⅱ,Ⅲ,Ⅳ group）,all be routine used of Midazolam,Etomidate and Vecuronium fou induced anesthesia and muscle relaxation;At the same time used target controlled infusion technology （TCI） were set four group with 10,20,30,40 ng/mL plasma concentration of drug infusion dezocine injection,recorded hemodynamic index Include the following each time point：before induction of anesthesia for 1 minutes （T 1）,the BIS value to 65（T 2）,immediately prior to endotracheal intubation（T 3）,tracheal intubation after 20 seconds （T 4）,skin incision after 20 seconds（T 5） and saw the sternum after 20 seconds （T 6）.Used the statistical software to compared between groups,within the group of hemodynamics changes difference.Results SP,DP,HR at different time points of Tracheal intubation after 20 seconds （T 4）,skin incision after 20 seconds （T 5） and saw the sternum after 20 seconds （T 6） compared with it of endotracheal intubation before,Ⅰ,Ⅱ group was significantly higher than Ⅲ,Ⅳ group,there are no significant difference between Ⅲ,Ⅳ group.Conclusion Dezocine plasma concentration of more than 30 ng/mL,it can satisfy the analgesic requirements in anesthesia initial stage of CABG operation.
出处
《中国当代医药》
2012年第30期86-87,89,共3页
China Modern Medicine
