瑞芬太尼复合丙泊酚用于房缺封堵术的快通道麻醉

目的观察瑞芬太尼复合丙泊酚用于右胸小切口房缺封堵术快通道麻醉的应激反应、血流动力学变化及术后恢复的影响。方法 22例患者,ASAI-Ⅱ级,择期行房间隔缺损封堵术,以瑞芬太尼及丙泊酚诱导和维持,维持脑电双频指数(BIS)于(50±10)。分别记录各时点平均动脉压(MAP),心率(HR)、中心静脉压(CVP)的变化,分别于各个时点抽取动脉血,测定血浆肾上腺素、去甲肾上腺素浓度和术后恢复情况。结果所有患者术中血流动力学平稳,各时点的肾上腺素(E)浓度无显著差异(P>0.05),血浆去甲肾上腺素(NE)浓度在诱导后气管插管前(T2)、切皮时(T4)比麻醉诱导前(T1)明显降低(P<0.05),气管插管后1min(T3)比麻醉诱导前(T1)明显增高(P<0.05)。术后恢复好,无术中知晓。结论瑞芬太尼复合丙泊酚用于右胸小切口房缺封堵术的麻醉安全有效,血流动力学平稳,能有效抑制应激反应,术后能早期拔管,适用心脏快通道麻醉。

Remifentanil and Propofol for Fast Track Anesthesia in ASD Occlusion

Objective To assess the efficacy of anesthesia with Remifentanil-Propofol for Fast Track Anesthesia in Thoracic Small Incision ASD Occlusion on stress response and hemodynamic changes. Methods Twenty-two patients with Atrial septal defect occlusion were included in this study.Anesthesia was induced with remifentanil-propofol and maintained with remifentaiail-propofol to keep bispectral index（BIS） values at （50±10） HR, MAP, CVP and recovery variables were recorded, and blood samples were taken for meastrments of concentration of epinephrine and norepinephrine during operation. Results All patients remained hemodynamically stabte, recovered smo6thly and intraoperative awareness was not noted. Epinephrine values showed no significant at different,time points. Norepinephrine was lower in T2, T4than,that in T1and norepinephrine was higher in T3 than that in T3. Conclusion The combination of remifentanii and propofol can offer hemodynamic stability and benefit of early extubation. It is effective to decrease stress response and fit the demand of fast track cardiac anesthesia.