不同浓度舒芬太尼复合丙泊酚对单孔腹腔镜气腹时心血管反应的影响
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摘要
目的分析不同浓度舒芬太尼复合丙泊酚对单孔腹腔镜气腹时心血管反应的影响。方法选取2016年6月至2017年6月我院行单孔腹腔镜手术患者80例,随机分为A组(27例)、B组(27例)、C组(26例)。A、B、C三组分别给予0.2μg/kg、0.4μg/kg、0.6μg/kg舒芬太尼复合丙泊酚麻醉。比较三组患者T_0、T_1、T_2、T_3的心率、平均动脉压。结果 T_0时,三组患者的心率、平均动脉压比较无统计学差异(P>0.05)。T_1时,A组的心率、平均动脉压明显下降,与B、C组比较差异有统计学意义(P<0.05)。T_2时,A组的心率、平均动脉压明显上升,与B、C组比较差异有统计学意义(P<0.05)。T_3时,三组的心率、平均动脉压比较无统计学差异(P>0.05)。结论低浓度舒芬太尼复合丙泊酚对单孔腹腔镜气腹时心血管反应的影响较大,中、高浓度的舒芬太尼复合丙泊酚对单孔腹腔镜气腹时心血管反应的影响较小,不能因单孔而减少舒芬太尼剂量。
Objective To analyze the influence of different concentrations of sufentanil combined with propofol on cardiovascular responses to single-port laparoscopic pneumoperitoneum. Methods 80 cases of patients undergoing single-port laparoscopic surgery in our hospital from June 2016 to June 2017 were selected and randomly divided into group A(27 cases), group B(27 cases) and group C(26 cases). Group A, group B and group C were respectively given 0.2 μg/kg, 0.4 μg/kg and 0.6 μg/kg of sufentanil combined with propofol. The heart rate and mean arterial pressure at T_0, T_1, T_2 and T_3 were compared among three groups. Results At T_0, no statistical difference was found in the heart rate and mean arterial pressure among three groups(P >0.05). At T_1, the heart rate and mean arterial pressure of group A significantly decreased, and had statistical differences compared with group B and group C(P <0.05). At T_2, the heart rate and mean arterial pressure of group A significantly increased, and had statistical differences compared with group B and group C(P <0.05). At T_3, no statistical difference was found in the heart rate and mean arterial pressure among three groups(P >0.05). Conclusions Low concentration of sufentanil combined with propofol has greater influence on cardiovascular responses to single-port laparoscopic pneumoperitoneum, and moderate and high concentration of sufentanil combined with propofol has less influence on cardiovascular responses to single-port laparoscopic pneumoperitoneum. The dose of sulfinin can not be reduced due to single port.
Objective To analyze the influence of different concentrations of sufentanil combined with propofol on cardiovascular responses to single-port laparoscopic pneumoperitoneum. Methods 80 cases of patients undergoing single-port laparoscopic surgery in our hospital from June 2016 to June 2017 were selected and randomly divided into group A(27 cases), group B(27 cases) and group C(26 cases). Group A, group B and group C were respectively given 0.2 μg/kg, 0.4 μg/kg and 0.6 μg/kg of sufentanil combined with propofol. The heart rate and mean arterial pressure at T_0, T_1, T_2 and T_3 were compared among three groups. Results At T_0, no statistical difference was found in the heart rate and mean arterial pressure among three groups(P >0.05). At T_1, the heart rate and mean arterial pressure of group A significantly decreased, and had statistical differences compared with group B and group C(P <0.05). At T_2, the heart rate and mean arterial pressure of group A significantly increased, and had statistical differences compared with group B and group C(P <0.05). At T_3, no statistical difference was found in the heart rate and mean arterial pressure among three groups(P >0.05). Conclusions Low concentration of sufentanil combined with propofol has greater influence on cardiovascular responses to single-port laparoscopic pneumoperitoneum, and moderate and high concentration of sufentanil combined with propofol has less influence on cardiovascular responses to single-port laparoscopic pneumoperitoneum. The dose of sulfinin can not be reduced due to single port.
引文
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[8]张卫,周立君,阚全程,等.不同剂量右美托咪定与小剂量氯胺酮预防瑞芬太尼复合麻醉后痛觉过敏的效果比较[J].临床麻醉学杂志,2013,29(5):435-438.
[2]王跃斌,孙广运.小剂量瑞芬太尼在全麻后抑制气管拔管心血管反应的临床效果分析[J].临床合理用药,2016,9(3B):32-33.
[3]吴静,刘立莉,杨帆.小剂量瑞芬太尼对全麻拔管期心血管反应的影响[J].南方医科大学学报,2012,32(9):1316-1318.
[4]阳婷婷,唐轶洋,张兴安.舒芬太尼与瑞芬太尼复合丙泊酚全凭静脉麻醉用于神经外科手术效果与安全性的系统评价[J].中国循证医学杂志,2013,13(12):1492-1499.
[5]时敬峰,韩景田,刘明.瑞芬太尼预输注对全麻病人气管插管时心血管反应的抑制[J].中国临床研究,2012,25(1):50-51.
[6]邱小弟,佘守章,许学兵,等.瑞芬太尼抑制喉罩插入心血管反应的半数效应室靶浓度[J].临床麻醉学杂志,2011,27(3):222-224.
[7]胡利国,潘建辉,李娟,等.瑞芬太尼联合舒芬太尼在老年患者全麻中的镇痛作用[J].临床麻醉学杂志,2013,29(2):133-136.
[8]张卫,周立君,阚全程,等.不同剂量右美托咪定与小剂量氯胺酮预防瑞芬太尼复合麻醉后痛觉过敏的效果比较[J].临床麻醉学杂志,2013,29(5):435-438.