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舒芬太尼预注对冠脉搭桥术患者麻醉诱导期血流动力学及镇静药物用量的影响 被引量:8

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摘要 目的 观察舒芬太尼预注对冠脉搭桥术患者麻醉诱导期血流动力学和镇静药物用量的影响。方法选取行冠脉搭桥术男性患者40例,年龄50~65岁,ASAⅡ~Ⅲ级,分为2组(P组及C组),每组20例,两组患者年龄、体质指数、术前平均动脉压(MAP)、心率(HR)、脑电双频指数(BIS)以及心排量(CO)、每搏变异度(SVV)差异无统计学意义(P〉0.05)。P组患者全麻诱导期间采取舒芬太尼提前静注后应用BIS监测指导镇静药(依托咪酯)的给药量。C组为对照组,常规全麻诱导,舒芬太尼不进行提前注射,虽进行BIS监测但镇静药均按照患者体重给予。观察两组患者麻醉前、意识消失即刻、插管前即刻、插管后即刻、插管后1 min的MAP、HR、BIS、CO和SVV值,诱导结束总结并记录依托咪酯用量以及血管活性药物用量。结果 P组患者应用依托咪酯以及血管活性药物剂量明显少于C组(P〈0.05)。P组气管插管前后比较BIS、MAP、HR、CO、SVV均没有明显变化(P〉0.05)。C组患者意识消失即刻和插管前即刻BIS明显低于P组(P〈0.05),组内比较插管后即刻比插管前即刻上升较为明显(P〈0.05)。C组患者插管前即刻MAP、CO较麻醉前下降,明显低于P组患者(P〈0.05);同时SVV上升,明显高于P组患者(P〈0.05)。C组患者插管前后MAP、CO、SVV波动较明显(P〈0.05)。结论 舒芬太尼提前预注在节省镇静药用量的同时能很好地维持冠脉搭桥手术诱导期患者的血流动力学稳定,具有积极的临床意义。
出处 《广东医学》 CAS 北大核心 2016年第9期1382-1384,共3页 Guangdong Medical Journal
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