不同浓度瑞芬太尼靶控输注在腹腔镜手术中应用.docVIP

不同浓度瑞芬太尼靶控输注在腹腔镜手术中应用【摘要】目的：观察不同靶控浓度瑞芬太尼复合丙泊酚静脉麻醉在腹腔镜手术中的应用。方法：29例择期腹腔镜手术病人随机分为3组，分别接受4 ng/ml，6 ng/ml，8 ng/ml的瑞芬太尼复合丙泊酚3 μg/ml靶控输注静脉麻醉。观察并记录插管前、插管后5分钟，建立气腹前及建立气腹后1、3、5、10和15分钟的心率和动脉收缩压数值。同时测量并记录气腹前和气腹后5分钟的血糖。结果：R1组建立气腹后血糖明显低于建立气腹前数值（Ｐ＜0.05），并且建立气腹后各时点的血压和心率与建立气腹前相比有明显差异。R2与R3组建立气腹前后血糖无显著变化。其中R2组病人的心率和血压在建立气腹前后无显著变化，但R3组病人心率在建立气腹后较气腹前显著减慢。 结论：靶控输注瑞芬太尼复合丙泊酚静脉麻醉可以应用于腹腔镜手术麻醉，而瑞芬太尼的最佳靶控血浆浓度为6ng/ml。 【关键词】瑞芬太尼；丙泊酚；腹腔镜；靶控输注 文章编号：1009-5519（2007）12-1753-03 中图分类号：R614 文献标识码：A Different concentration of target control infusion of remifentanil for laparoscopic surgery ZHANG Jie，LI Bin (Department of Anesthesiology，The First Affiliated Hospital of Zhengzhou University，Henan 450052，China) 【Abstract】Objective：To observe the effect of target control infusion of remifentanil with propofol during laparoscopic surgery with different concentration of remifentanil.Methods：30 patients undergoing laparoscopic surgery were randomly divided into three groups to receive a target control infusion of remifentanil and propofol. The concentration of propofol was set at 3 μg/ml，and the concentration of remifentanil in the three groups was 4 ng/ml，6 ng/ml and 8 ng/ml respectively.Heart rate(HR) and systolic blood pressure(SBP) were recorded at the time intervals of pre-intubation，5min after intubation，before intraperitoneal carbon dioxide insufflation and 1min，3min，5min，10min，15min after insufflation. The blood concentration of glucose(BGS) were also titrated and recorded before and after intraperitonael carbon dioxide insufflation.Results：In group R1，not only BGS was significantly higher after carbon dioxide insufflation compared with BGS before insufflation，but also HR and SBP were significantly higher at every time point after insufflation. There was no significant difference between BGS values in group R2 and R3. Also no significant difference was detected in the comparison of HR and SBP at each time point in group R2.In group R3，SBP has no significant change，but HR expressed