靶控输注舒芬太尼-丙泊酚在胰十二指肠切除术中的应用

目的评价靶控输注舒芬太尼-丙泊酚应用于胰十二指肠切除术的可行性。方法20例ASAⅠ～Ⅱ级胰十二指肠切除术患者,全麻诱导采用靶控输注舒芬太尼和丙泊酚,意识消失后静脉注射罗库溴铵0.6 mg/kg,当BIS值达到40～50时行气管插管,机械通气。气管插管后,调节丙泊酚靶浓度维持BIS在40～50,舒芬太尼靶浓度则根据动脉血压和心率来调节,观察整个手术麻醉过程中血流动力学的变化及术毕患者的清醒程度。结果20例中有18例在术后10 min内拔除气管导管,另有2例分别于术后30 min和45 min拔除气管导管。整个手术麻醉过程中,全部病例血流动力学稳定,术后患者苏醒迅速而且定向力好。结论胰十二指肠切除术应用靶控输注舒芬太尼-丙泊酚麻醉是一种安全、有效的麻醉方法。

Effect of Target-controlled Infusion of Sufentanil-propofol for Whipple's Surgery

Objective To investigate the effect of target-controlled infusion of sufentanil-propofol for Whipple's surgery.Methods Twenty patients were scheduled for Whipple's surgery.Induction of anesthesia was performed with target-controlled infusion with sufentanil and propofol.After intubation,anesthesia was maintained with propofol infusion titrated to maintain bispectral index between 40 and 50.The target concentration of sufentanil was titrated according to arteiral blood pressure and heart rate.Systolic blood pressure(SBP),diastolic blood pressure(DBP),mean artery pressure(MAP) and heart rate(HR) were recorded at various time points,i.e.immediately before tracheal intubation,2-minute after tracheal intubation,immediately after surgical incision,immediately after initiation of celiac exploration,1-hour after operation,and immediately after extubation.Results Eighteen patients were extubated in ten minutes after surgery,and the other two were extubated respectively in 30 minutes and 45 minutes after surgery.The hemodynamics of all the paitients was stable in the whole surgery;the analepsia was quick and the orientation force was good after surgery.Conclusion Target-controlled infusion of sufentani-lpropofol is a safety and effective method of anesthesia for Whipple's surgery.