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1.
舒芬太尼在无痛胃镜检查中的应用 总被引：1，自引：0，他引：1
黎荣福 《河北北方学院学报(医学版)》2008,25(5)
目的:探讨舒芬太尼复合丙泊酚在无痛胃镜检查中的麻醉效果。方法:137例ASAⅠ~Ⅱ级、接受无痛胃镜检查术的患者,随机分成2组,Ⅰ组(芬太尼组)68例和Ⅱ组(舒芬太尼组)69例。Ⅰ组芬太尼0.5μg/kg 丙泊酚1mg/kg iv;Ⅱ组舒芬太尼0.1μg/kg 丙泊酚1mg/kg iv。观察指标:BP、HR、SPO2、丙泊酚用量、苏醒时间、体动以及心动过缓等术中并发症的发生率。结果:Ⅱ组的丙泊酚用量较I组显著减少(P<0.05),Ⅱ组的苏醒时间较Ⅰ组显著缩短(P<0.05),两组的术中并发症的发生率无显著性差异(P>0.05)。结论:0.1μg/kg舒芬太尼复合1mg/kg丙泊酚适用于无痛胃镜检查术。 相似文献
2.
不同静脉麻醉药对罗库溴胺快速诱导气管插管的影响 总被引：1，自引：0，他引：1
目的:观察硫贲妥钠、依托咪酯以及异丙酚麻醉诱导对罗库溴铵的插管条件和神经肌肉阻滞程度的影响。方法:选择39例全麻择期手术患者,ASAⅠ~Ⅱ级,随机分为三组,分别采用硫贲妥钠5.0mg.kg-1、依托咪酯0.3mg.kg-1及异丙酚1.5~2.0mg.kg-1静脉诱导,静注罗库溴铵60s后行气管插管。记录气管插管即刻的T1和T4/T1值、插管时间,记录血流动力学参数变化、脉搏血氧饱和度,根据气管插管评分标准进行插管评分。结果:各组病人气管插管即刻的T1和T4/T1及插管时间组间比较无明显差异(P>0.05),三组病人在静注罗库溴铵后60s气管插管条件综合评分均为优良(P>0.05),但是依托咪酯比硫贲妥钠和异丙酚气管插管反应略少。结论:依托咪酯伍用罗库溴铵在静注后60s行快速诱导插管略优于硫贲妥钠和异丙酚。如果患者禁忌使用琥珀胆碱可以改用依托咪酯与罗库溴铵来完成快速诱导和气管插管。 相似文献
3.
He W Zhang FJ Wang SP Chen G Chen CC Yan M 《Journal of Zhejiang University. Science. B》2008,9(2):100-108
Background: Sevoflurane and propofol are effective cardioprotective anaesthetic agents, though the cardioprotection of propofol has not been shown in humans. Their roles and underlying mechanisms in anesthetic postconditioning are unclear.Mitochondrial permeability transition pore (MPTP) opening is a major cause of ischemia-reperfusion injury. Here we investigated sevoflurane- and propofol-induced postconditioning and their relationship with MPTP. Methods: Isolated perfused rat hearts were exposed to 40 min of ischemia followed by 1 h of reperfusion. During the first 15 min of reperfusion, hearts were treated with either control buffer (CTRL group) or buffer containing 20 μmol/L atractyloside (ATR group), 3% (v/v) sevoflurane (SPC group),50 μmol/L propofol (PPC group), or the combination of atractyloside with respective anesthetics (SPC ATR and PPC ATR groups). Infarct size was determined by dividing the total necrotic area of the left ventricle by the total left ventricular slice area (percent necrotic area). Results: Hearts treated with sevoflurane or propofol showed significantly better recovery of coronary flow,end-diastolic pressures, left ventricular developed pressure and derivatives compared with controls. Sevoflurane resulted in more protective alteration of hemodynamics at most time point of reperfusion than propofol. These improvements were paralleled with the reduction of lactate dehydrogenase release and the decrease of infarct size (SPC vs CTRL: (17.48±2.70)% vs (48.47±6.03)%,P＜0.05; PPC vs CTRL: (35.60±2.10)% vs (48.47±6.03)%, P＜0.05). SPC group had less infarct size than PPC group (SPC vs PPC:(17.48±2.70)% vs (35.60±2.10)%, P＜0.05). Atractyloside coadministration attenuated or completely blocked the cardioprotective effect of postconditioning of sevoflurane and propofol. Conclusion: Postconditioning of sevoflurane and propofol has cardioprotective effect against ischemia-reperfusion injury of heart, which is associated with inhibition of MPTP opening. Compared to propofol, sevoflurane provides superior protection of functional recovery and infarct size. 相似文献
4.
丙泊酚复合瑞芬太尼靶控静脉麻醉与静吸复合麻醉的临床观察 总被引：1，自引：0，他引：1
目的:比较丙泊酚复合瑞芬太尼靶控静脉麻醉与静吸复合麻醉的诱导和术后苏醒过程.方法:选腹腔镜胆囊切除术40例,ASA I—II级,15—66岁,随机分为静吸复合麻醉(C)组,丙泊酚瑞芬太尼靶控(R)组,每组20例,观察麻醉诱导,气管插管时的血压、心率,术毕停药后病人自主呼吸恢复时间,呼之睁眼时间,拔管时间,离开手术室时间,观察恶心、呕吐情况.结果:C组诱导时的收缩压低于R组,低血压者多于R组,插管反应发生率R组低于C组;二组病人术后自主呼吸恢复时间,呼之睁眼时间,拔管时间差异无显著性,恶心、呕吐发生率差异无显著性.结论:与静吸复合麻醉相比,异丙酚瑞芬太尼靶控输注麻醉诱导更平稳. 相似文献
5.
目的：探讨单独丙泊酚静脉麻醉下胃肠镜检查的可行性、安全性及临床效果。方法：自2009年3月至2009年9月,对800例患者应用丙泊酚进行无痛胃肠镜检查,另外1000例患者进行常规胃肠镜检查,观察两组胃肠镜检查的安全性和效果,检查完后由患者和内镜医生阅读并填写问卷调查表。结果：所有胃肠镜检查均顺利完成。检查前无痛组心理压力明显小于常规组,检查中无痛组不良反应明显比常规组少,两组间对比有显著性统计学差异（P≤0．05）;检查后不良反应对比无显著性差异（P〉0．05）。常规组检查中出现血压升高和心率增快。无痛组检查中血压、心率均有不同程度下降,与检查前比较有显著差异（P≤0．05）,与常规组比较亦存在显著差异（P≤0．05）,但多在正常范围,且为一过性,无须特殊处理,检查结束后迅速自行恢复。两组绝大多数患者检查前、中、后SaO2无明显差异,无痛组少部分患者出现SaO2降低,经积极处理迅速恢复正常。结论：单独丙泊酚静脉麻醉下胃肠镜检查是一种安全、舒适、有效的方法,但应注意严格掌握适应证与禁忌证,加强并发症的监测和处理。 相似文献
6.
Objective: The aim of this paper is to compare the propofol concentration in plasma and cerebrospinal fluid (CSF) in patients
scheduled for intracranial tumor removal and anaesthetized using propofol as part of a total intravenous anaesthesia technique.
Methods: Twenty-seven patients (ASA I–II) scheduled for elective intracranial tumor removal were studied. Anesthesia was induced
with 2 mg/kg propofol for 5 min and infused at 10 mg/(kg·h) for 5 min and then stopped. CSF and arterial blood were collected
simultaneously before infusion of propofol and at different time points after infusion of propofol according to bispectral
index (BIS) values. Concentrations of propofol in plasma and CSF were measured by HPLC with fluorescence detection. The correlation
coefficient and regression equation between plasma and CSF concentration of propofol were worked out by linear simple regression.
Results: The propofol CSF concentration that we measured was 1.46% of the plasma concentration. The coefficient of relation
between plasma and CSF concentration was 76.7%. Conclusions: The propofol CSF concentration was positively correlated with
and much lower than the plasma concentration. Discrepancies may result from high plasma protein binding of propofol, intracranial
pathology and sampling volume.
Project supported by Startup Foundation for Introducing Talent of Zhejiang University, China 相似文献
7.
Objective： To compare the effects of epidural anesthesia with 1.5% lidocaine and 0.5% ropivacaine on propofol requirements, the time to loss of consciousness （LOC）, effect-site propofol concentrations, and the hemodynamic variables during induction of general anesthesia guided by bispectral index （BIS） were studied. Methods： Forty-five patients were divided into three groups to receive epidurally administered saline （Group S）, 1.5% （w/w） lidocaine （Group L）, or 0,5% （w/w） ropivacaine （Group R） Propofol infusion was started to produce blood concentration of 4 lag/ml. Once the BIS value reached 40-50, endotracheal intubation was facilitated by 0.1 mg/kg vecuronium. Measurements included the time to LOC, effect-site propofol concentrations, total propofol dose, mean arterial blood pressure （MABP）, and heart rate （HR） at different study time points. Results： During induction of anesthesia, both Groups L and R were similar for the time to LOC, effect-site propofol concentrations, total propofol dose, MABP, HR, and BIS. The total doses of propofol administered until 1 min post-intubation were significantly less in patients of Groups R and L compared with Group S. MABP and HR were significantly lower following propofol induction compared with baseline values in the three groups, or MABP was significantly increased following intubation as compared with that prior to intubation in Group S but not in Groups R and L while HR was significantly increased following intubation in the three groups. Conclusion： Epidural anesthesia with 1.5% lidocaine and 0.5% ropivacaine has similar effects on the time to LOC, effect-site propofol concentrations, total propofol dose, and the hemodynamic variables during induction of general anesthesia. 相似文献
8.
蒋俊梅 《荆门职业技术学院学报》2008,23(9)
目的:探讨异丙酚、芬太尼联合静脉麻醉辅助结肠镜检查的效果。方法:将420例患者随机分为两组,自愿接受异丙酚、芬太尼静脉麻醉后行结肠镜检查者220例,未经静脉麻醉接受结肠镜检查者200例,比较两组患者完成结肠镜检查成功率,观察有无腹部疼痛和恶心、呕吐等副反应情况。结果:麻醉组检查成功率100%,均未诉腹部疼痛,恶心者占1.36%;未麻醉组检查成功率为95.5%,主诉腹部疼痛者占98.5%,主诉恶心、呕吐者占24.5%。检查效果有显著性差异,p均小于0.05。结论:异丙酚、芬太尼联合静脉麻醉用于结肠镜检查,能使患者安全、轻松地完成镜检,并减轻患者痛苦。 相似文献
9.
[目的]:观察丙泊酚用于老年心脏病病人行口腔颌面部手术时全麻诱导并经鼻气管插管情况.[方法]:选用65例老年心脏病病人行口腔颌面部手术用丙泊酚诱导并与硫贲妥钠相对比,观察插管前及插管后1、3、5 min不同时段血液动力学指标情况.[结果]:插管前两组平均动脉压(MAP),心率(HR)无显著性差异(P>0.05);插管后1、3、5 min不同时段丙泊酚组血液动力学波动明显低于硫贲妥钠组,二者有显著差异(P<0.01).[结论]:丙泊酚用于老年心脏病人行鼻腔插管优于硫贲妥钠等药物. 相似文献
10.
Xing Tao Ling-qiao Lu Qing Xu Shu-ren Li Mao-tsun Lin 《Journal of Zhejiang University. Science. B》2009,10(10):740-747
Objective: We compare the cardioprotective effects of anesthetic preconditioning by propofol and/or isoflurane in rats with ischemia-reperfusion injury. Methods: Male adult Wistar rats were subjected to 60 min of anterior descending coronary artery occlusion followed by 120 min of reperfusion. Before the long ischemia, anesthetics were administered twice for 10 min followed by 5 min washout. Isoflurane was inhaled at I MAC (0.016) in I group, whereas propofol was inhaled intravenously at 37.5 mg/(kg.h) in P group. A combination ofisoflurane and propofol was administered simultaneously in I+P group. Results: In control (without anesthetic preconditioning, C group), remarkable myocardial infarction and apoptosis accompanied by an increased level of cardiac troponin T were noted 120 rain after ischemia-reperfusion. As compared to those of control group, I and P groups had comparable cardioprotection. In addition, I+P group shares with I and P groups the comparable cardioprotective effects in terms of myocardial infarction and cardiac troponin T elevation. Conclusion: A combination of isoflurane and propofol produced no ad-ditional cardioprotection. 相似文献