七氟烷复合芬太尼用于成人麻醉诱导的临床研究

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1、七氟烷复合芬太尼用于成人麻醉诱导的临床研究浙江位I伤外科2011年1O月第16卷第5期ZHJJrrraumatic,October2011,Vo1.16,No.5?589??临床研究?七氟烷复合芬太尼用于成人麻醉诱导的临床研究宫尚珍原桂华万凌峰胡常恩【摘要】目的观察七氟烷在复合诱导时BIS(脑电双拼指数)与MAC(最低肺泡有效浓度)的相关性和m流动力学的变化.方法6O例行全身麻醉的患者(ASA分级I～Ⅱ)根据年龄的不同分为A,B两组.A组为≤4O岁;B组为41-69岁.开始吸人诱导时氧流量为6L/min,体积分数为8%七氟烷,嘱病人深呼吸

2、,意识丧失时给予维库溴胺O.1mg/kg,芬太尼2g/kg,BIS值降至40-55之后氧流量减为每分钟4L/min,维持BIS在40～55,SBP在90～120mmHg范围内调节七氟烷的浓度,3分钟后行气管插管.记录并分析患者纂础值,意识丧失时,气管插管时,插管后l,3分钟的BIS,MAC,BP(血压),HR(心率).结果①两组患者意识丧失时和气管插管时年龄,BIS与MAC有相关性(P<0.05);②两组患者的BIS和BP,HR无明显相关性(P>0.05);⑧两组病人诱导时血流动力学稳定.结论七氟烷复合芬太尼诱导时患者BIS和

3、MAC有相关性,BIS和BP,HR无明显相关性,诱导过程血流动力学比较平稳,可以嗣于成人.【关键词】芬太尼;七氟烷;麻醉诱导;MAC;BIS【中图分类号】R614【文献标识码】AClinicalanalysisofCO—inductionwithsevofluraneandfentanylinanesthesiaofadultsGONGShangzhen,YUANGuihua,WANLingfeng,et.ShaoxingCountyCentralHospital,Zhejiang312030,China【Abstract】0bjecti

4、veToexplorethecorrelationbetweenBISandMAC,thechangingofhemodynamicsinpatientswithCO—inductionofsevoflurane.Methods60patientswithgeneralanesthesia(ASAgrade:I～IIdegree)weredividedintotwogroupsbyage:groupA(1essthanand40yearsold),groupB(41to69yearsold).Whenpatientsbegantoinha

5、leinduction,theoxygenflowwas6L/min,sevofluranevolumefractionwas8%.Thenthepatientswereaskedfordeepbreath.Vecuronium(0.1mg/kg)andfentanyl(21xg/kg)wereinjectedwhenthepatientslosedconscious-ness.Reducedtheflowofoxygento4L/minwhenBISwas40to55andkeet)itstable.Adjustedtheconcent

6、rationofsevofluranetokeeptheSBPbe90~130mmHg.Trachealintubationwasperformed3minuteslater.RecordedthedataofBIS,MAC,BPandHRbeforetheanesthesia,andthetimepointoflossofconsciousness,trachealintubation,land3minutesaftertrachealintubation.ResultsThereiscorrelationbetweenage,BISa

7、ndMACwhenpatientslosedofconsciousnessandwhentrachealintubationwasdone(P<O.05).ThereisnoobviouscorrelationbetweenBIS,BPandHR.Hemodynamicsoftwogroupswerebothstable.ConclusionInthepatientswithCO—inductionofsevnnuraneandfentany1.thereiscorrelationbe.tweenBISandMAC,butBISha

8、snoobviouscorrelationwithBPandHR.Thehemodynamicswasstableduringtheinduction.Co-inductionofsevofl