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静脉注射瑞芬太尼对腹部手术患者异丙酚药代动力学和血流动力学的影响 被引量:6

THE EFFECT OF INTRAVENOUS INJECTION OF REMIFENTANIL ON THE PHARMACOKINETICS OF PROPOFOL AND HEMODYNAMICS IN PATIENTS WITH ABDOMINAL OPERATIONS
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摘要 目的:观察静脉注射瑞芬太尼对腹部手术患者异丙酚药代动力学和血流动力学的影响。方法:选取2014年3月至2015年6月在湖北省十堰市太和医院接受全麻的腹部患者为观察对象,并根据患者意愿将其分为对照组和观察组,每组各50例。对照组给予异丙酚麻醉,观察组给予瑞芬太尼联合异丙酚麻醉,观察两组患者药代动力学参数、血流动力学指标以及麻醉效果的差异。结果:两组患者的分布半衰期(T_(1/2a))、消除半衰期(T_(1/2β))、中央室分布容积(V1)、血浆清除率(CL)等药代动力学指标比较差异均无统计学意义(均P>0.05);与t0相比,对照组收缩压(SBP)、舒张压(DBP)及平均动脉压(MAP)变化的幅度均较观察组明显(P<0.05),而两组患者的血氧饱和度(SpO_2)比较差异无统计学意义(P>0.05);手术后,观察组视觉模拟评分(VAS)低于对照组(P<0.05),两组患者的Ramsay评分无明显差别(P>0.05)。结论:静脉注射瑞芬太尼麻醉对异丙酚药代动力学和腹部手术患者的血流动力学影响较小,且麻醉效果较好,适用于临床麻醉。 Objective:To observe the effect of intravenous injection of remifentanil on the pharmacokinetics of propofol and hemodynamics in patients with abdominal operations. Methods: Patients who received ab- dominal operations under general anesthesia in our hospital from March 2014 to June 2015 were selected and divided into a control group and an observation group, with 50 cases in each group. The patients in the control group received propofol, and those in the observation group received a combination of propofol and remifentanil. The pharmacokinetic parameters, hemodynamics and anesthetic effects of both groups were observed. Results: There were no significant differen ces in the pharmacokinetic parameters including half life of distribution (T1/2α), elimination (T1/2β), volume of the central compartment (V1) and plasma clearance rate (CL) between the two groups (P 〉0.05). The changes of SBP, DBP and MAP in t0-t6 were more obvious in the control group than those in the observation group ( P 〉0.05). There was no significant difference in the oxyhemoglobin saturation (SpO2) between the two groups. After surgery, the visual analogue scale (VAS) score of the observation group was lower than that of the control group, and there was no significant difference in the Ramsay scores between the two groups. Conclusion: Combination of remifentanil and propofol had less effect on the pharmacokinetics of propofol and hemodynamics of patients, and the anesthesia effect was better. It could be suitable for clinical anesthesia.
作者 陈兴寅 柴琼
出处 《广西医科大学学报》 CAS 2016年第6期992-995,共4页 Journal of Guangxi Medical University
关键词 全身麻醉 血流动力学 异丙酚 VAS general anesthesia hemodynamics propofol visual analogue scale
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