芬太尼复合丙泊酚全凭静脉麻醉剂量的临床研究

Clinical study of different dosage of fentanyl-propofol TIVA

目的 临床评价两种芬太尼复合丙泊酚全凭静脉麻醉 (TIVA)给药方法。方法 ASAⅠ～Ⅱ级、年龄 18～ 5 5岁的 40例择期行胸及上腹部手术病人随机分为芬太尼组 (F组 )和丙泊酚组(P组 ) ,每组 2 0人。F组以芬太尼 10 μg/kg +丙泊酚 1mg/kg进行诱导 ,维持采用芬太尼 5 / 4/ 3μg·kg-1·h-1+丙泊酚 5 / 4/ 3mg·kg-1·h-1输注方案 ;P组以芬太尼 2 μg/kg +丙泊酚 2mg/kg诱导 ,芬太尼 2 μg·kg-1·h-1+丙泊酚 10 / 8/ 6mg·kg-1·h-1方案维持麻醉。记录围术期血液动力学、儿茶酚胺和BIS等变化和术后情况。结果 F组在插管、切皮、术中探查、拔管时较P组血液动力学稳定 (P <0 0 5 ) ,儿茶酚胺无明显变化 (P >0 0 5 )。两组意识恢复时间相似。术后 4小时VAS和 2 4小时镇痛药用量F组均明显低于P组 (P <0 0 1)。SpO2 和RR监测显示无明显呼吸抑制。结论 (1)F组给药方法的血液动力学更为稳定 ,应激反应抑制良好。 (2 )F组与P组相比 ,效 /价比高。 (3)

Objective To evaluate clinically two different fentanyl propofol TIVA drug administration regime.Methods Forty ASAⅠ Ⅱ patients scheduled for surgery were randomly divided into two groups.Patients in F group were induced by fentanyl 10μg·kg -1 and propofol 1mg·kg -1 ,maintained by fentanyl 5/4/3μg·kg -1 ·h -1 and propofol 5/4/3mg·kg -1 ·h -1 .In P group,patients were induced by fentanyl 2μg·kg -1 and propofol 2mg·kg -1 ,maintained by fentanyl 2μg·kg -1 ·h -1 and propofol 10/8/6mg·kg -1 ·h -1 .The hemodynamic,respiratory and catecholamine changes were recorded perioperatively.Results After intubation,incision,exploration and extubation,the hemodynamics in F group was more stable than that in P group( P< 0 05).There were no significant changes in catecholamines in F group( P> 0 05).The awakening time in two groups was similar.There was no significant respiratory depression shown by SpO 2 and RR monitoring.Conclusion (1)The method used in F group can produce more stable hemodynamics and inhibit stress responses well.(2)F group has higher effect/price ratio than P group.(3)F group has a better postoperative analgesia.