[1]孙振涛△,韩雪萍#,王勇,等.舒芬太尼靶控输注辅助颈丛阻滞甲状腺手术效果[J].郑州大学学报(医学版),2009,(06):1227-1228.
 SUN Zhentao,HAN Xueping,WANG Yong,et al.Efficacy of sufentanil targetcontrolled infusion assist cervical plexus block thyroid surgery[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2009,(06):1227-1228.
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舒芬太尼靶控输注辅助颈丛阻滞甲状腺手术效果()
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2009年06期
页码:
1227-1228
栏目:
论著
出版日期:
2009-11-01

文章信息/Info

Title:
Efficacy of sufentanil targetcontrolled infusion assist cervical plexus block thyroid surgery
作者:
孙振涛△韩雪萍#王勇徐广田丹丹
郑州大学第一附属医院麻醉科;河南省高等学校临床医学重点学科开放实验室 郑州450052
Author(s):
SUN ZhentaoHAN XuepingWANG YongXU GangTIAN Dandan
Department of Anesthesiology,the First Affiliated Hospital,Zhengzhou University;Key Disciplines Laboratory Clinical Medicine Henan,Zhengzhou 450052
关键词:
舒芬太尼靶控输注颈丛阻滞镇痛镇静
Keywords:
sufentanil targetcontrolled infusion cervical plexus block sedation analgesia
分类号:
R602
摘要:
比较舒芬太尼靶控输注(TCI)及恒速输注辅助颈丛阻滞甲状腺手术的镇痛镇静效果。方法:80例ASAⅠ~Ⅱ级的择期甲状腺手术患者随机分为2组:舒芬太尼TCI组(A组)和舒芬太尼恒速输注组(B组),每组40例。颈丛神经阻滞后,A组手术开始前5 min启动舒芬太尼TCI,初始效应室浓度为0.15 μg/L,术中随时调整目标浓度。B组手术开始前5 min给予负荷剂量舒芬太尼0.1 μg/kg,然后以0.1 μg/(kg·h)起始速率恒速输注,根据患者情况调整输注速率,每次递增或递减0.02~0.03 μg/(kg·h)。监测2组麻醉前(T0)、颈丛阻滞后5 min(T1)、手术开始后5 min(T2)、手术开始后30 min(T3)、术中牵拉明显时(T4)及手术结束时(T5)的平均动脉压、心率、呼吸和脉搏氧饱和度,观察镇静镇痛程度,记录呼吸抑制、恶心呕吐等不良反应发生情况。结果:2组均获得满意的镇痛镇静,无不良反应发生,A组镇静评分(2.17±0.36),B组为(2.28±0.43),2组间差异无统计学意义(t=1.24,P=0.267)。2组平均动脉压、心率、呼吸及脉搏氧饱和度比较差异无统计学意义(F组间=0.33、0.89、1.80和0.01,P均>0.05),但时间点间比较除脉搏氧饱和度(F时间=0.50,P>0.05)外,平均动脉压、心率及呼吸差异均有统计学意义(F时间=3.64、6.01和4.96,P均<0.05)。与T0时间点比较,2组T1时间点的平均动脉压、心率和呼吸均增高(P均<0.01);B组T2时间点的心率、T4时间点的平均动脉压、心率、呼吸仍增高,T2时间点的平均动脉压降低(P均<0.01)。结论:舒芬太尼TCI辅助颈丛阻滞用于颈部手术安全有效,镇痛良好,较恒速输注血液动力学更稳定,呼吸抑制少,值得推广应用。
Abstract:
To evaluate the effects on hemodynamic and respiratory of sufentanil targetcontrolled infusion (TCI) and constant infusion sedation and analgesia assist cervical plexus block thyroid surgery.Methods:A total of 80 ASA I or Ⅱ elective thyroid surgery patients were randomly divided into two groups: sufentanil TCI group (Group A) and sufentanil constant infusion group (Group B),with 40 cases in each group. After cervical plexus block, 5 min before the start of surgery,Group A commencement TCI sufentanil,the lnitial Ce was 0.15 μg/L,and adjusted target concentration at any time. Group B,the loading dose of sufentanil was 0.1 μg/kg,the initial speed was 0.1 μg/(kg·h), adjusted the speed of infusing according to patient's situation with increase progressively or decrease progressively by 0.02~0.03 μg/(kg·h) each time. MAP, HR, RR,and SpO2 were recorded before anesthesia (T0), cervical plexus block after 5 min (T1),surgery began 5 min (T2), the operations began 30 min (T3), when operation traction obviously (T4) and at the end of operation (T5). Sedation, respiratory depression, muscle stiffness, nausea and vomiting, pruritus, and other adverse reactions were recorded too.Results:The analgesia score of Group A was (2.17±0.36),which didn’t differ from that (2.28±0.43) of Group B(t=1.24,P=0.267).At T1 point, MAP, HR and RR were higher than those at T0 point in both groups(P<0.01).MAP and HR at T2 and T4,and RR at T4 were changed compared with those at T0 point (P<0.01) in Group B.Conclusion: Sufentanil TCI assist cervical plexus block for thyroid surgery is safe and effective.

参考文献/References:

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备注/Memo

备注/Memo:
△男,1969年生,博士研究生,副教授,副主任医师,研究方向:麻醉、疼痛治疗的基础与临床 #通讯作者,女,1958年生,教授,主任医师,研究方向:麻醉学的基础与临床
更新日期/Last Update: 2010-05-14