摘要
目的探讨脑电双频指数(BIS),指导下丙泊酚或依托咪酯复合瑞芬太尼靶控输注对子宫切除术麻醉效果的影响。方法选取2014年2月至2016年9月济南军区总医院94例宫颈癌手术患者,采用随机数字法分为研究组和对照组,每组各47例。经过常规诱导后,研究组持续泵入依托咪酯复合瑞芬太尼,对照组持续泵入丙泊酚复合瑞芬太尼。观察并比较两组患者术中麻醉效果。结果研究组和对照组术中心率、收缩压、舒张压差异无统计学意义(F值分别为1.34、1.42、1.21,均P>0.05),两组患者平均清醒时间、麻醉诱导时间和拔管时间差异均无统计学意义(χ~2值分别为0.51、-0.97、0.31,均P>0.05)。研究组患者术后肌肉震颤、躁动的发生率显著低于对照组,差异具有统计学意义(χ~2值分别为3.86、5.28,均P<0.05),两组患者呕吐、恶心的发生率比较差异均无统计学意义(χ~2值分别为0.34、1.01,均P>0.05)。结论 BIS指导下依托咪酯复合瑞芬太尼靶控输注对子宫切除术麻醉效果良好,安全高效并且对心血管影响小,临床价值较高。
Objective To investigate the anesthetic effect of target-controlled infusion of propofol or etomidate combined with remifentanil on hysterectomy under bispectral index（ BIS） guidance. Methods Altogether 94 patients receiving cervical cancer surgery in Jinan Military Region General Hospital from February 2014 to September 2016 were selected and divided into research group and control group by random number,with 47 cases in each group. After routine induction,patients in the research group were given continuous infusion of etomidate and remifentanil and patients in the control group received continuous infusion of propofol and remifentanil. Intraoperative anesthesia effect in two groups was observed and compared. Results There was no significant difference in intraoperative heart rate,systolic blood pressure and diastolic blood pressure between two groups（ F value was 1. 34,1. 42 and 1. 21 respectively,all P〈 0. 05）. There was no significant difference between two groups in average awake time,mean time of anesthesia induction and extubation time（ χ^2value was 0. 51,-0. 97 and 0. 31,respectively,all P〉 0. 05）. Incidences of muscle tremors and restlessness in the research group were significantly lower than those in the control group,and the differences were statistically significant（ χ^2value was 3. 86 and 5. 28,respectively,both P〈 0. 05）.There was no significant difference in incidence of vomiting and nausea between two groups（ χ^2value was 0. 34 and 1. 01 respectively,both P〈 0. 05）. Conclusion Targeted infusion of etomidate combined with remifentanil under BIS has good anesthetic effect on hysterectomy. It is safe and effective,and has little effect on cardiovascular. Its clinical value is high.
出处
《中国妇幼健康研究》
2017年第8期932-934,共3页
Chinese Journal of Woman and Child Health Research
关键词
BIS
靶控输注
丙泊酚
依托咪酯
麻醉
瑞芬太尼
bispectral index（BIS）
target-controlled infusion
propofol
etomidate
anesthesia
remifentanil
