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1.
异丙酚与普鲁卡因静脉复合麻醉出现知晓的对比观察   总被引:2,自引:0,他引:2  
异丙酚除在临床上已广泛用于麻醉诱导外,也与镇痛药静脉复合用于麻醉维持[1],我们对异丙酚和普鲁卡因静脉复合麻醉患者术后分别进行随访,调查了两组的术中知晓及术终知晓情况,现报道如下。资料与方法一般资料 异丙酚组和普鲁卡因组各168例,ASAⅠ~Ⅱ级,年龄16~72岁,体重45~110kg。麻醉方法 普鲁卡因组:以2%硫喷妥钠2mg/kg、安定0.4mg/kg、芬太尼0.1mg及琥珀胆碱100mg行麻醉诱导,快速气管内插管,术中用1%普鲁卡因0.06%琥珀胆碱复合液静滴维持,术中分次追加氟哌啶0.1mg/kg,芬太尼总量达10μg/kg,关腹后停复合液。…  相似文献   

2.
异丙酚诱导插入喉罩的临床观察   总被引:9,自引:1,他引:8  
20例静脉全麻病人静注慢丙酚2.5mg/kg诱导插入喉罩,评价其临床效果。结果表明,异丙酚诱导起效快,平均28.6s眼睑反射消失,插管时18例下颌松弛满意,17例单次剂量后对喉罩耐受良好,3例因呃逆呛咳等分别追加20 ̄40mg相同药物。诱导后收缩压和舒张压较诱导前明显下降(P〈0.001),而插入喉罩并没有引起明显血液动力学改变,诱导中16例出现呼吸暂停,但几分钟内即恢复自主呼吸。作者认为,异丙酚  相似文献   

3.
异丙酚静脉麻醉镇静催眠深度的研究   总被引:14,自引:2,他引:12  
目的:探讨异丙酚静脉全麻适宜镇静催眠深度及异丙酚的合理用药量。方法:30例ASAI ̄Ⅱ级病人,用异丙酚进行麻醉诱导,记录神志消失及对电刺激无运动反应或异丙酚诱导用量达到6mg·kg^-1时的脑电图参数及异丙酚用量。气管插管后,随机将病人分为两组,A组和B组分别调整异丙酚输入速度,维持BIS水平于神志消失及诱导结束时的BIS值及其以下5以内的范围内。结果:神志消失和诱导结束时BIS分别为71±8和5  相似文献   

4.
不同静脉全麻药对腹腔镜胆囊切除术后呕吐的影响   总被引:4,自引:0,他引:4  
呕吐是麻醉手术后常见的并发症 ,现就短效静脉全麻药异丙酚、依托咪酯、硫喷妥钠麻醉对腹腔镜胆囊切除术后呕吐的影响报告如下。资料与方法一般资料 同期腹腔镜胆囊切除术 32 5例 ,ASAⅠ~Ⅱ级 ,随机分为三组。麻醉方法 Ⅰ组 114例 ,异丙酚 2mg/kg诱导麻醉 ;Ⅱ组 10 7例 ,依托咪酯 0 4mg/kg诱导麻醉 ;Ⅲ组 10 4例 ,2 5 %硫喷妥钠 5mg/kg诱导麻醉。给药顺序依次为东莨菪碱0 3mg、芬太尼 5 μg/kg、静脉全麻药、琥珀胆碱 1 5mg/kg。诱导后控制呼吸 ,潮气量 10ml/kg ,呼吸频率 14次 /分 ,二氧化碳气腹压力 15…  相似文献   

5.
异丙酚和硫喷妥钠对琥珀胆碱肌松效应的对比研究   总被引:3,自引:0,他引:3  
目的:对比研究民丙酚和硫喷妥钠对琥珀胆碱肌松效应的影响。方法:34例拟行喉显微手术病人随机分为两组,分别给予异丙酚或硫喷妥钠静脉复合麻醉。全麻诱导后,静注琥珀胆碱1.5mg/kg后气管插管,继之连续静滴0.1%琥珀胆碱溶液维持肌松松状态至术毕,以加速度仪监测。结果与结论:与硫喷妥钠组相比,异丙酚麻醉时琥珀胆碱的肌松起效更快,停药后肌松恢复也更快。  相似文献   

6.
目的评价小儿开腹手术时小剂量瑞芬太尼合用咪达唑仑对术后拔管的影响。方法小儿开腹手术40例,全凭静脉麻醉。随机分为两组:Ⅰ组:异丙酚、维库溴胺、芬太尼静脉复合麻醉;Ⅱ组:咪达唑仑、异丙酚、维库溴胺、瑞芬太尼静脉复合麻醉,气管插管后行人工控制呼吸。对比观察两组患儿停药后自主呼吸恢复时间、术毕至气管导管拔除时间、拔管后5min不吸氧时的SpO2及术后恶心呕吐的发生率。结果停药后病人自主呼吸恢复时间及术毕至导管拔除时间:Ⅱ组明显短于Ⅰ组(P<0.01)。气管导管拔除后5min不给面罩吸氧时的SpO2:与麻醉诱导前比较Ⅰ组降低(P<0.05),Ⅱ组差异无显著性(P>0.05);Ⅱ组高于Ⅰ组(P<0.01)。术后恶心呕吐:Ⅰ组3例,Ⅱ组无1例发生,两组差异有显著性(P<0.05)。结论瑞芬太尼作为麻醉镇痛药,术毕自主呼吸恢复快,易于早期拔管,术后恶心呕吐发生率较低,适用于小儿开腹手术的麻醉。  相似文献   

7.
异丙酚对冠状动脉旁呼术病人术前血流动力学的影响   总被引:4,自引:0,他引:4  
目的和方法:对19例择期冠状动脉旁呼术病人麻醉诱导前各静注异丙酚1-2mg/kg,观察其后2、4、8min血流动力学效应。结果:用药后2min平均动脉压,肺动脉压、外周血管阻力、心每搏量、每搏指数和左心室搏出功指数均经对照组降低非常显著;由于心率明显增快,故心输出量和心脏指数无改变。上述各血流学参数至4min已恢复至对照组。结论:异丙酚扩张血管、降低外周阻力,从而短暂降低血压,用于冠状动脉旁路术的  相似文献   

8.
异丙酚麻醉诱导对体循环和肺循环的影响   总被引:27,自引:1,他引:26  
目的:观察异丙酚麻醉诱导后体循环和肺循环的改变,对气管插管应激反应的影响。方法:11例择期神经外科手术患者采用静注2.5mg/kg异丙酚诱导麻醉,诱导前后及气管插管后记录SP,DP,MAP和HR,应用热稀释技术测定心输出量等参数。  相似文献   

9.
异丙酚辅助下腹部手术硬膜外麻醉的临床观察   总被引:13,自引:0,他引:13  
目的:比较硬膜外辅助用药的作用。方法:30例病人随机分为三组,每组10例。麻醉完善后,组Ⅰ,先静注异丙酚08mg/kg,继之用微泵持续输注2mg·kg-1·h-1;组Ⅱ,静注安定5mg,继之微泵持续输注异丙酚2mg·kg-1·h-1。组Ⅲ,给予哌替啶50mg、氟哌啶25mg静注。结果:异丙酚组在用药后5min呼吸抑制明显,10min后渐正常;组Ⅲ在10至30min之间表现较强的呼吸抑制。组Ⅰ在用药后5至10min血压降低明显。组Ⅰ、Ⅱ病人VAS优良率达90%,组Ⅲ仅为40%。结论:以安定5mg加异丙酚2mg·kg-1·h-1辅助硬膜外麻醉具有诱导与维持平稳舒适、对循环呼吸功能影响轻微、术后恢复好、抗呕吐作用强等优点  相似文献   

10.
目的与方法:36例6-12岁小儿,ASAⅠ级,随机分三组,每组12例,用药分别为硫喷妥钠5mg/kg、异丙酚2.5-3mg/kg和异丙酚2.5-3mg/kg复合芬太尼2g/kg对比观察各组小儿麻醉诱导时间、气管插管时的心血管反应以及药物的不良反应,结果:S一观察证实异丙酚与硫喷妥钠麻醉诱导时间相近,但注射局部疼痛和全身不适发生率较高。结论:异丙昨合芬太尼后不仅能明显缩短麻醉诱导时间,并能有效地抑制  相似文献   

11.
Three different dosage schemes of propofol infusions combined with a fixed-rate alfentanil infusion were investigated in total intravenous anaesthesia. In 30 premedicated patients, divided at random into three groups, anaesthesia was induced with propofol 2 mg.kg-1 immediately followed by an alfentanil infusion 10 micrograms.kg-1.min-1 as a loading dose which was decreased after ten minutes to a maintenance dose of 1 microgram.kg-1.min-1. Vecuronium bromide 0.1 mg.kg-1 was used as the muscle relaxant. After induction of anaesthesia a propofol infusion 2 mg.kg-1.hr-1 was started in group A, 3 mg.kg-1.hr-1 in group B and 4 mg.kg-1 hr-1 in group C. At signs of light anaesthesia supplementary bolus doses of 20 mg propofol and 1 mg alfentanil were given. The patients' lungs were ventilated with air-oxygen (FIO2 0.35). The mean systolic and diastolic blood pressures showed no statistical significant differences between the three groups. A significant (P less than 0.01) decrease of the mean systolic and diastolic blood pressures was present after induction of anaesthesia and tracheal intubation. Recovery was uneventful in all but one patient, who had ventilatory depression that responded to naloxone (0.2 mg IV). Awareness did not occur in any patient. The only difference between the three groups was the higher number of supplementary bolus doses of propofol and alfentanil needed in group A (P less than 0.01). In total intravenous anaesthesia propofol 3 and 4 mg.kg-1.hr-1 as a maintenance dose combined with a two-step fixed-rate alfentanil infusion provided smooth anaesthesia and uneventful rapid recovery.  相似文献   

12.
We propose the use of an intravenous propofol/propofol auto-co-induction technique as an alternative to propofol/midazolam for induction of anaesthesia. We have studied 54 unpremedicated ASA 1 or 2 patients undergoing day-stay anaesthesia for minor orthopaedic surgery. All received 10 micrograms.kg-1 or alfentanil before induction, followed by either midazolam 0.05 mg.kg-1, propofol 0.4 mg.kg-1 or saline, and 2 min later, a propofol infusion at a rate of 50 mg.kg-1.h-1 until loss of eyelash reflex. We compared pre- and postinduction haemodynamic changes, complications at insertion of a laryngeal mask airway and recovery from anaesthesia in the three groups. Both co-induction techniques showed less postinduction hypotension and significant reduction of the total induction dose of propofol when compared to the control group. In the propofol/propofol group there was a decreased incidence of apnoea during induction of anaesthesia. These patients were discharged from hospital 2 h after the end of anaesthesia whereas patients in the midazolam/propofol group were discharged after 2 1/2 h (p < 0.001).  相似文献   

13.
This open, non comparative study was designed to establish a suitable dose regime for propofol when used as the main anaesthetic agent and given as a continuous infusion. Thirty patients (ASA I and II) were studied; five received muscle relaxants and were excluded from the analysis of maintenance and recovery. Immediately after an i.v. bolus dose of fentanyl (2 micrograms X kg-1), anaesthesia was induced in all patients with a mean dose of 2.03 mg X kg-1 propofol. Apnoea at induction was seen in 14 patients, with a mean duration of 151 s (range: 20 to 360 s). Mean, systolic and diastolic arterial pressures and heart rate decreased slightly but statistically significantly following induction. Fourteen patients, four of whom received propofol into a vein of the hand, noted pain on the injection site without venous sequelae immediately nor 24 h after anaesthesia. The mean duration of anaesthesia from induction to the patient ability to obey a simple command was approximately 40 min (range: 10 to 95 min). The mean infusion rate of propofol during maintenance was 0.86 +/- 0.04 mg X kg-1 X min-1. During maintenance, a satisfactory depth of anaesthesia was achieved in 23 patients without any further bolus injection of propofol. The mean time from stopping the infusion to eye opening on verbal command was 6.2 min, whilst that for orientation was 8.4 min. The anaesthesist assessed the quality of recovery as good or adequate in all the patients, who all were satisfied by the anaesthesia. No major adverse reactions occurred during or after anaesthesia and the incidence of minor side-effects was low.  相似文献   

14.
Propofol 2.5 mg/kg was compared with thiopentone 5 mg/kg as an induction agent for elective Caesarean section. Thirty-two healthy women with cephalopelvic disproportion were included in an open randomised study. The placental transfer of propofol was also studied in 10 other mothers given a single dose of 2.5 mg/kg. The induction characteristics and haemodynamic response to propofol and thiopentone were similar. Side effects were rare with both agents, but propofol caused more discomfort on injection compared to thiopentone. Recovery times were shorter after propofol as evaluated by time to orientation, recovery scoring after anaesthesia and measurements with the Maddox wing. Rapid placental transfer and significant fetal uptake were detected for propofol. There was no significant neonatal depression as assessed by Apgar scores and blood gas analyses. Propofol appears to be a suitable alternative to thiopentone as an induction agent for anaesthesia in elective Caesarean section.  相似文献   

15.
K. E. Tighe  & J. A. Warner 《Anaesthesia》1997,52(10):1000-1004
Forty-eight patients undergoing day-case anaesthesia were asked to complete pre- and postoperative tests of psychomotor function in order to study the influence of co-induction with midazolam in conjunction with propofol/alfentanil anaesthesia on postoperative psychomotor recovery. The study was placebo controlled and double blind with patients receiving either 0.03 mgkg−1 of midazolam or saline 2 min before induction of anaesthesia with propofol and alfentanil. Patients who underwent co-induction with midazolam had significantly impaired concentration and rapidity of response but improved accuracy and vigilance when compared with those who received saline. The study confirmed that co-induction with a subanaesthetic dose of midazolam reduced the induction dose of propofol by up to 50%. We conclude that co-induction with midazolam reduces psychomotor recovery in the immediate postoperative phase following propofol infusion anaesthesia.  相似文献   

16.
The purpose of this study was to determine the optimum bolus dose of propofol required to provide excellent conditions for tracheal intubation following inhalational induction of anaesthesia using 5% sevoflurane without neuromuscular blockade. Twenty-eight children, aged three to seven years, requiring anaesthesia for short duration surgery were recruited. Two minutes after beginning the inhalational induction with 5% sevoflurane and 60% nitrous oxide, a predetermined dose of propofol was injected over 10 seconds. Propofol dose was determined using the Dixon's up-and-down method, starting from 3 mg/kg (0.5 mg/kg as a step size). Laryngoscopy was performed 50 seconds after propofol injection. The optimum dose of propofol required for excellent intubating conditions was 1.39 +/- 0.37 mg/kg in 50% of children during inhalation induction using 5% sevoflurane and 60% nitrous oxide in the absence of neuromuscular blocking agents. From probit analysis, the 95% effective dose of propofol was 2.33 mg/kg (95% confidence interval 1.78 to 6.21 mg/kg).  相似文献   

17.
Background: Metoclopramide has been shown to reduce the dose of thiopentone required for induction of anaesthesia. When propofol is used, there have been conflicting results with one small study showing a reduction in the anaesthetic dose and one study failing to demonstrate any effect.
Methods: Two groups of 30 patients were studied. The patients were randomised to receive either saline 0.03 ml/mg or metoclopramide 0.15 mg/kg 5 min before a manual injection of propofol at a set rate.
Results: This study shows a reduction in the dose of propofol required for the induction of general anaesthesia following an intravenous dose of metoclopramide. The induction dose of propofol was reduced by 24%.
Conclusions: The mechanism of reduction of propofol dose by metoclopramide is unknown; it may involve GABA or result from a more complex interaction involving dopamine blockade by metoclopramide.  相似文献   

18.
Speed of onset, duration of action and recovery time for a bolus injection of atracurium were measured in two groups of patients. In group I anaesthesia considered of propofol, fentanyl, nitrous oxide and oxygen mixture. The induction dose of propofol was 2 mg/kg-1 followed by an infusion of 9.0 mg/kg-1/h-1 for first half hour and 4.5 mg/Kg-1/h-1 subsequently. In group II anaesthesia consisted of isoflurane, fentanyl, nitrous oxide and oxygen mixture. Isoflurane was given upon clinical needs. Speed of onset, duration of action, and recovery time for atracurium were measured in the two groups. No statistically significant differences between speed of onset and duration of action between the two groups were found. The recovery period from T1 = 10% to T1 = 70% twitch response was considerably longer with isoflurane (25 min +/- 6) than with propofol (18 min +/- 3) (p less than 0.01). Results obtained suggest that for adequate relaxation during tracheal intubation smaller doses of atracurium are not needed during isoflurane than propofol administration. Because of the longer recovery period of residual neuromuscular blockade during isoflurane anaesthesia decreasing doses of atracurium and careful monitoring of twitch depression tension are also suggested.  相似文献   

19.
Propofol and alfentanil infusion   总被引:2,自引:0,他引:2  
B. KAY 《Anaesthesia》1986,41(6):589-595
In 42 patients undergoing major surgery, anaesthesia was induced by intravenous alfentanil 10 micrograms/kg together with methohexitone 1.5 mg/kg or propofol 2 mg/kg. An infusion of six times these doses per hour was then started; the rate was varied subsequently as indicated by the monitoring of arterial blood pressure, heart rate, EEG and frontalis electromyogram. The mean duration of infusion was 76.7 minutes for propofol and 74.5 minutes for methohexitone and the infusion was stopped about 10 minutes before the end of surgery in each group. The induction dose differed, but the total dose requirement for the two drugs was similar. In every case, anaesthesia was satisfactory. Methohexitone caused a significant rise in mean pulse rate throughout anaesthesia (p less than 0.05, paired t-test). There was no change in mean pulse rate during propofol infusion. The dose of alfentanil used provided excellent control of autonomic reflexes, with negligible respiratory depression. Naloxone was not required. Propofol provided better anaesthesia than methohexitone, with fewer side effects (p less than 0.05, Chi squared test), easier control of the level of narcosis and faster recovery (p less than 0.001, t-test after log transformation).  相似文献   

20.
Comparison of etomidate and propofol for anaesthesia in microlaryngeal surgery   总被引:13,自引:0,他引:13  
Propofol and etomidate were compared as hypnotics in total intravenous anaesthesia for microlaryngeal surgery combined with jet ventilation. Two groups of 15 patients were studied. In group 1, propofol 2.0 mg/kg was used for induction. For maintenance a continuous infusion of 12 mg/kg/hour was used for the first 10 minutes, followed by 9 mg/kg/hour for the next 10 minutes and 6 mg/kg/hour thereafter. In group 2, the induction dose of etomidate was 0.3 mg/kg followed by continuous infusion of 1.8 mg/kg/hour for 10 minutes, 1.5 mg/kg/hour for the next 10 minutes and 1.0 mg/kg/hour thereafter. Alfentanil was given for analgesia and suxamethonium for muscle relaxation. The propofol group showed better surgical conditions, more stable anaesthesia and better recovery according to the Steward score. Recovery times to opening eyes on command were comparable for both groups.  相似文献   

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