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环泊酚-阿芬太尼在泌尿外科短小手术中的应用

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目的 评价环泊酚-阿芬太尼在泌尿外科短小手术中的应用效果。方法 将该院泌尿外科拟行全身麻醉手术的患者80例,采用随机数字表法分为环泊酚-阿芬太尼组(C组)和丙泊酚-阿芬太尼组(P组)。C组静脉注射环泊酚0。4 mg/kg,P组静脉注射丙泊酚1。5~2。0 mg/kg,脑电双频指数(BIS)<60时,继续静脉注射阿芬太尼10 μg/kg,罗库溴铵0。6 mg/kg;待改良警觉/镇静评分(MOAA/S评分)为0时,置入喉罩进行机械通气。麻醉维持期间C组静脉输注环泊酚0。8~1。2 mg·kg-1·h-1,P组静脉输注丙泊酚4~6 mg·kg-1·h-1。于麻醉诱导开始时(T0)、置入喉罩时(T1)、输尿管镜进入时(T2)、手术开始10 min(T3)、手术结束时(T4)记录患者的心率(HR)、血压(BP)、氧饱和度(SpO2)、呼气末二氧化碳分压(PetCO2)、BIS值及 MOAA/S评分。记录意识消失时间、手术时间、麻醉苏醒时间、药物使用剂量,记录患者给药时注射痛、术中患者低血压、心动过缓等不良反应发生情况。结果 两组患者各个时间点HR、SpO2、PetCO2、BIS值及MOAA/S评分、手术时间、意识消失时间、麻醉苏醒时间比较,差异无统计学意义(P>0。05)。与P组比较,C组镇静药物使用量更少(P<0。05),C组T1~T3 时收缩压和舒张压及T4 舒张压升高(P<0。05);与T0 比较,C组和P组T1~T4 的收缩压降低,C组T2~T4 舒张压降低,P组T1~T4 舒张压降低(P<0。05);与P组比较,C组给药时注射痛、术中低血压发生率降低(P<0。05)。结论 环泊酚-阿芬太尼用于泌尿外科短小手术优于丙泊酚-阿芬太尼。
Application of ciprofol-alfentanil in short urological surgery
Objective To evaluate the application effect of ciprofol-alfentanil in short urological surgery.Methods A total of 80 patients who were to undergo urological general anesthesia surgery in this hospital were divided into two groups by random number method:ciprofol-alfentanil group(group C)and propofol-alfentanil group(group P).Group C was injected with ciprofol 0.4 mg/kg,group P was injected with propofol 1.5-2.0 mg/kg,and when the bispectral index(BIS)was<60,the intravenous injection of alfen-tanil(10 μg/kg)and rocuronium bromide(0.6 mg/kg)was continued.When the modified alertness/sedation score(MOAA/S score)was 0,the laryngeal mask was placed and mechanical ventilation was used.During the maintenance period,ciprofol 0.8-1.2 mg·kg-1·h-1 was infused intravenously in group C,and propofol 4-6 mg·kg-1·h-1 was infused intravenously in group P.The heart rate(HR),blood pressure(BP),oxygen saturation(SpO2),end-tidal carbon dioxide(PetCO2),BIS and MOAA/S score were recorded at the begin-ning of anesthesia induction(T0),laryngeal mask insertion(T1),ureteroscopy entry(T2),10 min after sur-gery(T3)and the end of surgery(T4).The consciousness disappearance time,operation time,anesthesia re-covery time,drug dosage,injection pain during induction,hypotension,bradycardia and other adverse reactions during the operation were recorded.Results There was no significant difference in HR,SpO2,PetCO2,BIS value,MOAA/S score,operation time,consciousness disappearance time,and anesthesia recovery time be-tween the two groups at each time point(P>0.05).The dosage of sedative drugs in group C was less than that in group P(P<0.05).Compared with group P,systolic blood pressure and diastolic blood pressure at T1-T3 and diastolic blood pressure at T4 increased in group C(P<0.05).Compared with T0,systolic blood pressure at T1-T4 in group C and group P decreased,diastolic blood pressure at T2-T4 in group C de-creased,and diastolic blood pressure at T1-T4 in group P decreased(P<0.05).Compared with group P,the injection pain and the incidence of intraoperative hypotension were reduced in group C(P<0.05).Conclusion Cipro-fol-alfentanil is superior to propofol-alfentanil in short urological surgery.

ciprofolpropofolalfentanilhypotensionurological surgery

侯雅欣、何士凤、张婉月、汤西玲、孙振涛

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郑州大学第一附属医院麻醉科,郑州 450052

环泊酚 丙泊酚 阿芬太尼 低血压 泌尿外科手术

河南省医学科技攻关计划项目

2018010006

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(5)
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