靶控输注法对丙泊酚复合不同浓度芬太尼的临床观察

目的观察靶控输注丙泊酚和不同浓度芬太尼的临床效应。方法38例行下腹部手术的患者,随机分为2组,靶控输注丙泊酚3mg.mL-1分别复合芬太尼2ng.mL-1(A组)及4ng.mL-1(B组)。观察2组病人在麻醉前、气管插管后、切皮后的平均动脉压(MAP)、心率(HR)、心率变异性指数(LF/HF),并于气管插管后、切皮后、手术30,60,90及120min,观察2组病人的脑电双频指数(BIS)变化。结果A组病人在气管插管后,MAP、LF/HF均显著高于麻醉前;切皮后MAP、HR、LF/HF与麻醉前比较无显著性差异(P>0.05)。B组各指标在气管插管、切皮后与麻醉前比较,均无显著性差异(P>0.05)。2组各时间点的BIS值在35~58,组间比较无显著性差异。结论靶控输注丙泊酚3mg.mL-1伍用芬太尼4ng.mL-1,可以有效抑制气管插管和切皮反应,并可获得满意的麻醉深度;而伍用芬太尼2ng.mL-1可以有效抑制切皮反应,但不能抑制气管插管反应。

Clinical study of propofol with different concentration of fentanyl by target- controlled infusion

Objective To assess the clinical effect on the propofol and fentanyl withdifferent concentration were both administered by target-controlled infusion.Methods Thirty-eight patients, scheduled for lower abdominal surgery, wererandomly assigned to two groups: propofol combined fentanyl with 2ng.mL-1(groupA,n=19);propofol combined fentanyl with 4ng.mL-1(group B,n=19).MAP(mean arterial pressure),HR( heart rate),LF/HF (low frequency/high frequency)at post-intubation and post-incision were compared with those at pre-anesthesia.And bispectral index (BIS )at post-intubation, post-incision and 30,60,90,120min of the surgery were observed. Results MAP, LF/HF at post-intubation andpost-incision in group A were significantly higher than those at pre-anesthesia(P<0.05, P<0.01).There was no difference in MAP, HR and LF/HF of group A comparedpost-incision with pre-anesthesia (P>0.05), and of group B compared post-intubation,post-incision with pre-anesthesia (P>0.05). BIS at each time period wasnot different between two groups(P>0.05). Conclusion Target-controlled infusionof propofol (3mg.mL-1) and fentanyl(4ng.mL-1) could suppress the hemodynamicresponse to tracheal intubation and incision; while fentanyl (2ng.mL-1) could onlyrestrain the hemodynamic response to incision. Both concentration of fentanylwith propofol(3mg.mL-1) obtained satisfactional depth of anesthesia.