下腹部手术麻醉中不同靶浓度瑞芬太尼与异丙酚的作用研究

On the Function of Different Target Concentration of Remifentanil and Propofol in the Anesthesia of Hypogastrium Operation

目的 研究下腹部手术麻醉患者应用不同靶浓度瑞芬太尼和异丙酚的作用效果。方法 将我院收治的下腹部手术麻醉患者为研究对象,并按随机分组法分为3组,均固定瑞芬太尼靶浓度,A组为6ng/ml,B组为8ng/ml,C组为10ng/ml,同时改变异丙酚靶浓度,范围为2-4μg/ml,观察比较各组的麻醉效果。结果 T1时刻A组的收缩压（SBR）高于B组,心率（HR）高于C组,差异有统计学意义（P〈0.05）;而T2、T3时刻比较,A组的SBR以及HR均较B、C组高（P〈0.05）。随时间推移,去甲肾上腺素（NE）各时点比较,T1时刻A组的NE高于C组,而血清皮质醇（COR）低于B、C组;T2、T3时刻A组的NE均显著高于B、C组,但3组COR变化无显著差异性（P〉0.05）。C组自主呼吸恢复时间、拔除气管导管时间、指令反应时间和离室时间均较长,而其睁眼时间较短（P〈0.05）。结论 将瑞芬太尼靶浓度调节为8ng/ml,可取得较为明显的麻醉镇痛效果。

Objective To study the specific function of different target concentration of remifentanil and propofol for patients receiving hypogastrium operation anesthesia . Methods The patients receiving hypogastrium opera‐tion anesthesia in our hospital were chosen as research target and were randomly divided into three groups ,each re‐ceiving a fixed concentration of remifentanil ,6 ng/m1 for group A ,8 ng/mlfor group B and 10 ng/mlfor group C . Simultaneously ,the concentration of propofol was changed ,and the range was 2 -4 μg/ml .An observation was made on the anesthesia effects of each group . Results In contrast ,the patients＇systolic blood pressure（SBR） and heart rate（HR） for group A were both higher at different time （P〈0.05） .As time went on ,the patients＇NE for group A were higher at different time .There were no significant change in CUR for the three groups（P〉0.05） . The patients of group C experienced a longer period in spontaneous breathing recovery time ,removing endotracheal tube time ,instruction reaction time and staying‐in operating‐room time . Conclusion A conspicuously better an‐esthesia effect is achieved w hen the target concentration of remifentanil is adjusted to 8 ng/ml .