摘要
目的：观察异丙酚芬太尼全静脉麻醉的临床应用效果。方法：１４例择期在气管插管全身麻醉下行腹部手术的患者，接受芬太尼总量８μｇ／ｋｇ静脉注射、异丙酚“目标控制性输注法”使脑电双频谱指数降至５５～７０。实验中分别观察麻醉诱导前（基础值）、气管插管前即刻、气管插管后２ｍｉｎ、切皮前、手术操作期５个时相的麻醉效果，并观察平均动脉压（ＭＡＰ）、心率（ＨＲ）、氧饱和度的改变。采用近红外线光谱仪监测脑氧合血红蛋白（ＨｂＯ２）、还原血红蛋白（Ｈｂ）、全血红蛋白（ＴＨｂ）变化。结果：异丙酚芬太尼全静脉麻醉期间ＭＡＰ维持稍偏低但平稳状态，ＨＲ改变不大，ＨｂＯ２、Ｈｂ及ＴＨｂ均有所下降。手术开始后，ＭＡＰ和ＨＲ均呈一定程度升高。结论：异丙酚芬太尼全静脉麻醉时，手术应激反应仍存在，对脑氧合功能影响不大，脑血流有所降低，对血流动力学及脑氧合脑血流动力学均无明显不利效应。
Objective:To observe clinical effect of total intravenous anesthesia(TIVA) with propofol and fentanyl.Methods:In fourteen patients undergoing elective abdominal surgical operation with general anesthesia,the bispectral index(BIS) was decreased to 55 70 with the intravenous injection of fentanyl(a total dosage of 8 μg/kg) and infusion of propofol(target controlled infusion).The changes in anesthetic results,mean arterial pressure(MAP),heart rate(HR),cerebral oxyhemoglobin(HbO 2),hemoglobin(Hb) and total Hb(with a near infrared spectoscope) were observed respectively during the following periods:before anesthesia,before endotracheal intubation,two minutes after intubation,before skin incision and during operation.Results:During TIVA with propofol and fentanyl,reduced MAP with its well maintaining,little change of HR,and a little decreased cerebral HbO 2,Hb and total Hb were shown.But the MAP and HR was increased after initiation of operation.Conclusion:During TIVA with propofol and fentanyl,the surgical stress was still present.Although the cerebral blood flow was a little decreased,the cerebral oxygenation was well protected.It suggests that there was no significant side effects on the hemodynamics and cerebral oxygenation.
出处
《中日友好医院学报》
1999年第3期143-146,共4页
Journal of China-Japan Friendship Hospital
关键词
麻醉
静脉内
二异丙酚
芬太尼
anesthesia
intravenous
propofol
fentanyl
spectra
Fourier analysis infrared
