星状神经节阻滞稳定全麻气管内插管及切皮时应激反应的初步研究

为观察应用星状神经节阻滞 (SGB)后全麻诱导气管内插管及手术切皮时内分泌的变化 ,将神经外科择期手术病人按麻醉方法的不同 ,分为阻滞组 (S组 ,n =1 4 ,于麻醉诱导前 5min行左SGB)与对照组 (N组 ,n =1 4 )进行对比观察。测量入室 (t0 )、气管插管后 1min(t1)、手术开始切皮 (t2 ) 3个时间的血浆皮质醇 (COR)、催乳素 (PRL)和胰岛素 (INS)浓度以及收缩压 (SBP)、舒张压 (DBP)和心率 (HR)。结果 :S组 3个时间的COR及PRL呈下降趋势、INS呈上升趋势 ;N组 3个时间的COR及PRL呈上升趋势、INS呈下降趋势 ;且SBP、HR、COR和PRL组内差比较均为N组 >S组 (P <0 .0 5和P <0 .0 1 )。显示SGB后诱导气管内插管及切皮时的SBP、HR及COR、PRL和INS变化相对较小。提示全麻诱导前行SGB具有抑制气管内插管及手术切皮时应激反应和稳定血流动力学的作用。     

The effects of paeoniflorin monomer of a Chinese herb on cardiac ion channels

Background  Because of the potential proarrhythmic effect of current antiarrhythmic drugs, it is still desirable to find safer antiarrhythmic drugs worldwide. Paeoniflorin is one of the Chinese herb monomers that have different effects on many ion channels. The present study aimed to determine the effects of paeoniflorin on cardiac ion channels.

Methods  Whole-cell patch-clamp technique was used to record ion channel currents. L-type calcium current (I_Ca-L), inward rectifier potassium current (I_K1), and transient outward potassium current (I_to1) were studied in rat ventricular myocytes and sodium current (I_Na), slow delayed rectifier current (I_Ks), and HERG current (I_Kr) were investigated in transfected human embryonic kidney 293 cells.

Results  One hundred μmol/L paeoniflorin reduced the peak I_Ca-L by 40.29% at the test potential of +10 mV (from (–9.78±0.52) pA/pF to (–5.84±0.89) pA/pF, n=5, P=0.028). The steady-state activation curve was shifted to more positive potential in the presence of the drug. The half activation potentials were (–11.22±0.27) mV vs. (–5.95±0.84) mV (n=5, P=0.007), respectively. However, the steady-state inactivation and the time course of recovery from inactivation were not changed. One hundred μmol/L paeoniflorin completely inhibited the peak I_Na and the effect was reversible. Moreover, paeoniflorin inhibited the I_K1 by 30.13% at the test potential of –100 mV (from (–25.26±8.21) pA/pF to (–17.65±6.52) pA/pF, n=6, P=0.015) without effects on the reversal potential and the rectification property. By contrast, 100 μmol/L paeoniflorin had no effects on I_to1, I_Ks or I_Kr channels.

Conclusions  The study demonstrated that paeoniflorin blocked I_Ca-L, I_Na, and I_K1 without affecting I_to1, I_Ks, or I_Kr. The multi-channel block effect may account for its antiarrhythmic effects with less proarrhythmic potential.

     

异丙酚对气管切开插管心血管功能的影响

目的　观察异丙酚对喉部手术气管切开插管时心血管功能的影响。方法　选择喉部手术需气管切开术病人 2 0例 ,随机分成异丙酚组 (P组 )和对照组 (C组 )。P组在异丙酚麻醉 (切皮前静注 1～ 2mg·kg-1)和局麻下 ,C组在局麻下行气管切开术。观察病人收缩压 (SBP)、舒张压 (DBP)、心率 (HR)的变化。结果　C组SBP、DBP在气管插管时较P组升高 (P <0 0 5 )。C组DBP在切皮时、插管后 1min、3min较P组升高 (P <0 0 5 )。C组HR在切皮时较P组升高(P <0 0 5 )。两组血氧饱和度的变化无显著性差异 (P >0 0 5 )。结论　异丙酚可减轻气管切开时的心血管反应     

超声引导星状神经节阻滞在老年冠心病患者腹腔镜胆囊切除术中的应用

目的 评价超声引导星状神经节阻滞(SGB)在老年冠心病患者腹腔镜胆囊切除术中的效果。 方法 选择择期行腹腔镜胆囊切除术且合并老年冠心病的患者50例,随机分为两组,每组25例,SGB组于麻醉诱导前行右侧SGB,对照组在同一位置注射等量生理盐水,之后两组患者均接受常规全身麻醉。记录患者全身麻醉前(T₀)、气管插管即刻(T₁)、手术切皮即刻(T₂)、术毕(T₃)以及术后6 h(T₄)的平均动脉压(MAP)和心率(HR); 检测患者各时间点的血浆肾上腺素(E)、去甲肾上腺素(NE)和B型尿钠肽(BNP)浓度; 记录两组患者穿刺部位血肿、感染、恶心、呕吐、胸闷、呼吸抑制等不良事件的发生情况。 结果 两组患者的人口学资料及术前MAP、HR及血浆E、NE、BNP浓度差别均无统计学意义(P>0.05)。SGB组于T₁～T₄各时间点的MAP和HR以及血浆E和NE的浓度均低于对照组,差别有统计学意义(P<0.05); 两组患者各时间点的血浆BNP浓度和不良事件发生率差别均无统计学意义(P>0.05)。 结论 SGB有助于控制应激,维持患者血流动力学稳定,用于老年冠心病患者腹腔镜胆囊切除术是安全有效的。     

Imbalance of endogenous homocysteine and hydrogen sulfide metabolic pathway in essential hypertensive children

Background  Hypertension is a common disease of the cardiovascular system. So far, the pathogenesis of primary hypertension remains unclear. The elaboration of its pathogenesis is an important topic in the field which calls for urgent resolution. The aim of this study was to probe into the metabolic imbalance of homocysteine (Hcy) and hydrogen sulfide (H₂S) in children with essential hypertension, and its significance in the pathogenesis of essential hypertension.
Methods  Twenty-five children with essential hypertension and 30 healthy children with normal blood pressure were enrolled in the study. The medical history was investigated and a physical examination was conducted on the subjects. Plasma Hcy content was examined by fluorescence polarization immunoassay (FPIA). The plasma H₂S level was detected by a modified method with a sulfide electrode. Data were presented as mean±standard deviation. The t test was applied to the mean values of both groups. Pearson linear correlation analysis was applied to the plasma Hcy and H₂S as well as to the systolic pressure against the plasma H₂S/Hcy ratio.
Results  Plasma Hcy, an intermittent metabolite of the endogenous methionine pathway, was markedly increased but plasma H₂S, a final product of this pathway was significantly decreased in hypertensive cases when compared with normal subjects ((Hcy: (12.68±9.69) µmol/L vs (6.62±4.79) µmol/L (t=2.996, P<0.01); H₂S: (51.93±6.01) µmol/L vs (65.70±5.50) µmol/L) (t=-8.670, P<0.01)). The ratio of plasma H₂S/Hcy in children with hypertension was 5.83±2.91, while that of the control group was 11.60±3.30, and the difference is significant with a t=-6.610 and P<0.01. A negative correlation existed between plasma Hcy and H₂S concentrations, r=-0.379, P<0.05. And a negative correlation was found between systolic blood pressure and the plasma H₂S/Hcy ratio, r=-0.687, P<0.05.
Conclusion  There was a metabolic imbalance of homocysteine and hydrogen sulfide in essential hypertensive children.

     

单侧星状神经节阻滞对全麻气管插管循环反应的影响

选择27例ASAⅠ级择期上腹部手术患者,随机分成对照组、SGB组、SGB+F(芬太尼)组,每组9例。观察气管插管前后SBP、MAP、HR和RPP化。结果提示,SGB对气管插管循环反应有一定抑制作用。插管瞬间、插管后2min、4min与对照组有明显差异(P<0.01),SGB+F组则能基本消除气管插管时的循环反应。     

右星状神经节阻滞在全身麻醉气管插管时对循环的影响

目的 观察右星状神经节阻滞在全身麻醉气管插管时对循环的影响.方法 106例外科全身麻醉手术患者随机分为星状神经节阻滞 (SGB) 组56例和对照组50例.观察气管插管前后SBP、DBP、MBP、HR和RPP的变化.结果 SGB对气管插管循环反应有明显抑制作用,插管后SGB组1 min (T3) 、5 min (T4) 、10 min (T5) 时SBP、DBP、MBP、HR、RPP反应程度明显低于对照组 (P<0.05) .结论 右星状神经节阻滞能明显抑制全身麻醉气管插管时的循环反应.     

香丹注射液不同提取部位对麻醉大鼠血流动力学的影响(英文)

目的 探讨香丹注射液不同提取部位对麻醉大鼠血流动力的影响。方法 将大鼠随机分为7组：生理盐水组、香丹注射液组、香丹注射液石油醚提取部位组(a)、氯仿提取部位组(b)、醋酸乙酯提取部位组(c)、正丁醇提取部位组(d)、水提取部位组(e),给药剂量为 16 g 生药/kg,静脉注射方式给药。用股动脉插管、右颈总动脉心室插管和连续记录肢体Ⅱ导联心电图的方法观察给药前和给药后5、10 和 15 min 大鼠的心率 (HR)、收缩压 (SBP)、舒张压 (DBP)、平均压 (MAP)、左心室收缩压 (LVSP)、左心室终末舒张压 (LVEDP)、左心室内压最大上升速率 (+dp/dt_max)、左心室开始收缩至 dp/dt_max 的间隔时间 (t-dp/dt_max) 和左心室内压最大下降速率 (-dp/dt_max) 的变化。结果 静脉注射相应的受试物后,石油醚提取部位组(a)和乙酸乙酯提取部位组(c)对麻醉大鼠血流动力学的各项指标无显著性影响 (P＞0.05);氯仿提取部位组(b)能使大鼠 SBP、DBP、MAP 显著升高 (P＜0.05);水提取部位组(e)能使大鼠 SBP 显著升高 (P＜0.05);正丁醇提取部位组(d)能使大鼠 SBP、DBP、MAP、LVSP 和-dp/dt_max 显著升高 (P＜0.05);香丹注射液五个不同提取部位对 HR、LVEDP、+dp/dt_max 和 t-dp/dt_max 指标无显著性影响 (P＞0.05)。结论 香丹注射液的正丁醇部位提取物具有增强心肌收缩功能和改善心肌舒张功能。     

全身麻醉诱导前星状神经节阻滞对气管插管患者循环系统的影响

【目的】研究观察左侧星状神经节阻滞(L-SGB)对高血压患者气管内插管期循环系统的影响。【方法】ASAⅡ~Ⅲ级择期上腹部手术的老年高血压患者30例,随机分为星状神经节阻滞组(SGB组)和非星状神经节阻滞组(NSGB组),每组各15例。SGB组在麻醉诱导前10 min采用第6颈椎气管旁穿刺法行L-SGB。记录入手术室后5 min(T0)、阻滞后10 min(T1)及插管后即刻(T2)、2 min(T3)、5 min(T4)各时点的SBP、MAP、HR,并计算RPP。【结果】NSGB组T2~T4时间点SBP、MAP、HR及RPP较本组插管前T0及T1时间点明显升高(P<0.05),SGB组T2~T4时间点SBP、MAP、HR及RPP较本组插管前T0及T1时间点变化不明显(P>0.05);NSGB组和SGB组在插管前T0及T1时间点比较各参数无明显差异(P>0.05),插管后T2~T4各时间点比较差异有统计学意义(P<0.05)。【结论】L-SGB可以有效抑制老年高血压患者气管插管期的循环反应。     

Elevated plasma lipoprotein-associated phospholipase A2 activity is associated with plaque rupture in patients with coronary artery disease

Background  Lipoprotein-associated phospholipase A₂ (Lp-PLA₂) has recently been shown to be positively related to coronary events in patients with coronary artery disease (CAD). However, direct evidence about the relationship between circulation Lp-PLA₂ activity and vulnerable plaque in patients with CAD remains lacking.

Methods  Plasma Lp-PLA₂ activity was determined in 146 consecutive patients with CAD who underwent clinically-indicated coronary angiography and preinterventional intravascular ultrasound (IVUS).

Results  Eighty-three patients were included in the final analysis after the initial screening. Sixty (72.3%) were acute coronary syndrome (ACS) patients and 23 (27.7%) were stable angina pectoris (SAP) patients. Plaque rupture occurred in 39 (47.0%) patients, and 34 (87.2%) were from ACS patients and 5 (12.8%) from SAP patients. There were no significant differences in clinical and angiographic characteristics between patients with plaque rupture and those without plaque rupture, except for smoking, high-sensitive C-reactive protein (hs-CRP) level and Lp-PLA₂ activity (all P <0.05). IVUS measurement uncovered that patients with plaque rupture had more frequent positive remodeling (74.4% vs. 43.2%, P=0.004), soft plaques (64.1% vs. 36.4%, P=0.012) and higher remodeling index (1.13±0.16 vs. 0.99±0.11, P=0.041) as compared with those without plaque rupture. Multivariate Logistic regression analysis showed that plasma Lp-PLA₂ activity was independently associated with plaque rupture after adjusting for smoking, positive remodeling and soft plaque (Model 1: odds ratio (OR) 1.13, 95% confidence interval (CI) : 1.06–1.20) or adjusting for smoking, hs-CRP level, positive remodeling and soft plaque (Model 2: OR 1.11, 95%CI: 1.04–1.19).

Conclusions  Plasma Lp-PLA₂ activity is associated with plaque rupture in patients with CAD, independently of traditional CAD risk factors, hs-CRP level and IVUS parameters. Lp-PLA₂ may be a risk marker for vulnerable plaques.

     

不同麻醉方法对胆囊切除术病人血糖及相关激素的影响

目的:观察比较不同麻醉方法对胆囊切除术病人血糖、胰岛素和皮质醇的影响。方法将40例择期行胆囊切除术的病人随机分为全麻复合硬膜外腔阻滞组(Ⅰ组)和全麻组(Ⅱ组),各20例。分别于麻醉前(t0)、切皮后30min(t1)、切皮后90min(t2)和术毕6小时(t3)测定血中血糖(GLU)浓度和胰岛素(INS)、皮质醇(COR)值。结果两组患者术中GLU、INS值较麻醉前升高,Ⅱ组GLU、INS值各个时相较麻醉前升高显著(P<0.05)术毕6h仍高。Ⅰ组患者GLU、INS值各时相与麻醉前相比变化幅度小,术毕6h基本恢复达麻醉前水平或更低。Ⅰ组GLU浓度和Ins值变化明显小于Ⅱ组(P<0.01)。两组患者于切皮后30min、90min皮质醇(COR)值升高明显(P<0.05),升高幅度Ⅱ组显著(P<0.05)。结论:全麻复合硬膜外腔阻滞麻醉方法用于胆囊切除术,对血中GLU浓度和INS、COR值变化影响最小,控制术中应激反应效果显著,有利于机体较快恢复,明显优于单纯全麻。     

两种麻醉方法用于气管切开及插管的效果比较

目的观察瑞芬太尼复合咪达唑仑能否减轻喉肿瘤患者气管切开及插管时的心血管反应并同时降低知晓发生率。方法择期喉肿瘤手术患者30例,年龄35～55岁,ASA为Ⅰ～Ⅱ级,喉阻塞为Ⅰ～Ⅱ度,随机分为氟芬合剂组（Ⅰ组）、瑞芬太尼＋咪达唑仑组（R组）,每组15例。所有患者在1％利多卡因局部浸润麻醉下行气管切开,气管切开之前,Ⅰ组患者静脉注射氟芬合剂2mL,R组患者缓慢静脉注射咪达唑仑50μg·kg^-1,继之瑞芬太尼0．05μg·kg^-1·min^-1持续输注。气管切开完成即将插管时,Ⅰ组患者静脉注射氟芬合剂2mL,R组患者缓慢静脉注射瑞芬太尼1μg·kg^-1。（大于1min）,记录局部浸润麻醉前（T0）、插管前即刻（T1）、插管成功即刻（T2）、麻醉诱导后2min（T3）的HR、MAP、SpO2;记录麻醉诱导时得普利麻的用量;记录气管切开过程中患者有无躁动、呛咳等反应。术后随访患者对气管切开及插管过程的知晓情况。患者SpO2〈90％定义为呼吸抑制。结果与Tn比较,Ⅰ组T1时的MAP及HR无明显变化,T2时MAP及HR明显升高（P〈0．05）,T3时MAP及HR明显降低（P〈0．05）;R组T1及T2时MAP及HR无明显变化,T3时MAP与Tn比较有所下降,但无统计学意义,而HR明显降低（P〈0．05）。与Ⅰ组比较,T2时R组MAP及HR明显降低（P〈0．05）,而T1时MAP明显升高（P〈0．05）。所有患者均无明显呼吸抑制。两组患者气管插管完成后麻醉诱导所需得普利麻量有显著差异（P〈0．01）;与Ⅰ组比较,R组呛咳、躁动等插管反应及插管知晓发生率明显降低（P〈0．01）。结论在局部麻醉的基础上,瑞芬太尼复合咪达唑仑能明显减轻气管切开及插管引起的心血管反应及知晓发生率。     

星状神经节阻滞预防气管内插管期心血管反应的临床观察

目的 观察右侧星状神经节阻滞（R—SGB）对气管内插管期心血管反应的影响。方法 ASA Ⅰ～Ⅱ级择期上腹部手术患者40例，随机分为两组各20例。Ⅰ组为空白对照组，Ⅱ组为R—SGB组。记录入室（t0）、SGB后（t1）、气管插管后1min（t2）、3min（t3）、5min（t4）各时点的SBP、MAP、DBP、HR，并计算RPP。结果 Ⅰ组SBP、HR、RPP、MAP于插管后1、3、5min均显著升高，与插管前相比具有明显的差异（P〈0．01）；而Ⅱ组插管后各参数与插管前相比无统计学意义（P〉0，05），但插管后1、3、5min各时点的参数变化明显低于Ⅰ组（P〈0．01）。结论 R—SGB可以有效抑制气管插管期的心血管反应。     

艾司洛尔对全麻插管时心血管反应的临床观察

目的研究艾司洛尔预防由气管插管引起的血液动力学变化。方法80例全麻病人随机分为两组,A组为应用艾司洛尔组2.0mg/Kg,B组为对照组。静注咪唑安定、丙泊酚、芬太尼和维库溴铵诱导,气管内插管。监测给药前、插管前及插管后1、3、5及10min心率(HR)、收缩压(SBP)、舒张压(DBP)。结果B组在插管过程中HR明显增快,与A组比较有显著差异(P<0.05)。A组SP、DP插管过程中有短时间轻度增高,B组增高明显且持续时间较长,两组比较有显著差异(P<0.01)。结论艾司洛尔在诱导前应用可有效缓解气管插管时的心血管反应。     

不同静脉麻醉药对诱导和气管插管期间血压、ET和NO的影响

目的 探讨硫喷妥钠、异丙酚、依托咪酯诱导对气管插管期间血压、脉搏及其内皮素(endothelin,ET)、一氧化氮(nitric oxide,NO)的影响.方法 择期气管插管全麻患者40例,随机分为3组:硫喷妥钠组(T组)、异丙酚组(P组)、依托咪酯组(E组).常规全麻诱导气管插管,分别在诱导前、诱导后插管前、插管后1、3、5 min记录血压、心率,并同时收集血样,分别采用放射免疫技术和硝酸还原酶法测定血中ET、NO的浓度.结果 全麻诱导后P组血压下降幅度最大,P组ET显著降低,T组和P组的NO显著升高.气管插管后1 min各组血压、脉搏均显著升高,各组ET、ET/NO均升高,NO均降低.结论 3种药物临床剂量对血压的抑制程度分别为异丙酚＞硫喷妥钠＞依托咪酯,并与对应时间点体内ET、NO的变化有相关关系.     

喉罩置入和视可尼喉镜气管插管在全麻诱导期对循环和BIS影响的比较

目的比较全麻诱导期喉罩置入和视可尼气管内插管对患者心血管反应和脑电双频指数(BIS)的影响。方法选择择期行鼻内窥镜全麻手术的患者60例,ASAⅠ～Ⅱ级,随机分为喉罩置入组(Ⅰ组)和视可尼气管插管组(Ⅱ组),每组30例。麻醉诱导和维持采用靶控输注丙泊酚和瑞芬太尼全静脉麻醉。比较各组患者诱导前(T1),诱导后(T2),喉罩置入或视可尼气管插管后即刻(T3)、1min(T4)、3min(T5)、5min(T6)时平均动脉压(MAP)、心率(HR)、BIS值的变化。结果Ⅰ组喉罩置入前后MAP、HR、BIS值组内比较差异无统计学意义(P>0.05);Ⅱ组T3、T4、T5的MAP、HR较T2时点差异无统计学意义(P>0.05),但BIS值明显升高(P<0.05),且在T3、T4、T5时明显高于Ⅰ组(P<0.05)。结论在相同麻醉深度下,全麻诱导期使用喉罩置入或视可尼气管内插管均可保持患者循环系统稳定,但视可尼气管内插管可使中枢神经兴奋性增高。     

无肌松药气管插管联合右侧星状神经节阻滞在口咽部手术中的应用

观察无肌松药气管插管联合右侧星状神经节阻滞(SGB)在口咽部手术中应用的可行性与安全性.择期全身麻醉下行口咽部手术患者60例,随机分为无肌松药全麻诱导组(无肌松组)和无肌松药全麻诱导联合右星状神经节阻滞组(联合组),每组30例.记录患者诱导前(T0)、气管插管前即刻(T1)、气管插管后即刻(T2)、手术开始即刻(L)时的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)、呼吸末二氧化碳浓度(PETCO2);及患者手术后4、8、12、24 h各时点的VAS评分.结果显示两组气管插管满意率及术后苏醒差异无统计学意义.联合组在T2和T3时点的MAP和HR较无肌松组有明显降低;且在T2及T3时点HR减慢,联合组术后各时点的VAS评分较无肌松组降低,差异有统计学意义(P＜0.05).无肌松药气管插管联合右侧星状神经节阻滞可提供良好的气管插管条件,且血流动力学平稳,术后苏醒优良,并能减轻术后咽痛.     

盐酸艾司洛尔对气管内插管应激反应的影响与给药时间的关系

目的：探讨盐酸艾司洛尔（ESM）用于预防气管内插管应激反应的临床效应。方法：选择胸、腹及下肢择期全麻手术者60例，按先后顺序随机将病例分成A、B、C三组，每组20例。A组诱导前静注ESM1．5mg/kg,1min注完；B组ESM改诱导后静注，注完后立即气管内插管、C组用同容量生理盐水代替ESM，三组诱导用药相同。结果：A、B组收缩压（SDP）、舒张压（DBP）、平均动脉压（MAP）及心率（HR）除插后即刻高于（P＜0．05）术前基础值外，插管后1、5、10min以上各参数与基础值基本接近，而C组SDP、DBP、MAP及HR插管后即刻明显高于（P＜0．01）术前基础值，插管后5min以上各参数仍高于术前基础值（P＜0．05），且插管反应较A、B两组剧烈。A组窦缓发生率明显高于B组（P＜0．05）。结论：ESM对预防气管内插管的应激反应有一定的预防作用，但不足以完全抑制气管内插管的应激反应。将ESM诱导后用药能有效地减少窦缓的发生。     

探讨GlideScope视频喉镜在临床麻醉中行气管插管的可行性

目的探讨GlideScope视频喉镜在临床麻醉中行气管插管的可行性。方法选择首都医科大学附属复兴医院妇产科就诊的经口气管插管全身麻醉下行妇科腹腔镜手术的患者100例,ASAⅠ～Ⅱ级,分为2组,即:Ⅰ组(G),Ⅱ组(M),年龄(45±15)岁,常规麻醉诱导〔芬太尼(2～3)μg.kg-1,异丙酚2 mg.kg-1,维库溴铵0.1 mg.kg-1〕。Ⅰ组采用GlideScope视频喉镜,Ⅱ组采用直接喉镜实施经口气管插管。记录显露声门时间、插管时间、喉部显露情况及麻醉诱导气管插管期间不同时间点(T1、T2、T3、T4)平均动脉压(MAP)、心率(HR)。结果 G组满意显露声门的时间为(15.38±5.21)s;M组为(14.21±3.11)s。G组气管插管的时间为(30.22±11.31)s;M组为(30.11±12.23)s。2组麻醉诱导气管插管期间与基础值T1比较,T2及T3时段MAP降低(P<0.05),T4时段心率增加显著(P<0.05),2组间差异无统计学意义(P>0.05)。结论 GlideScope视频喉镜在临床麻醉中行气管插管过程中能安全有效地显露声门,气管插管刺激及损伤较小,能解决部分临床困难气管插管问题并可减少医生交叉感染的危险。     

舒芬太尼与芬太尼在神经外科手术麻醉中的应用比较

目的:比较舒芬太尼和芬太尼用于神经外科手术麻醉时的血流动力学变化.方法:选择56例神经外科肿瘤手术病人,随机分舒芬太尼组(S组,n=28)和芬太尼组(F组,n=28).麻醉诱导采用丙泊2.0 mg/kg,琥珀胆碱1.5 mg/kg,S组用舒芬太尼0.4μg/kg,F组用芬太尼3 μg/kg,气管插管后机械通气,给予维库...