单纯靶控输注瑞芬太尼的安全性

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1、09年会-临床麻醉与研究单纯靶控输注瑞芬太尼的安全性作者单位：卫生部北京医院麻醉科邮编：100730作者姓名：彭文平左明章【摘要】目的观察单纯靶控输注瑞芬太尼的安全性。方法40例择期全麻手术患者，以血浆靶控方式输注瑞芬太尼，按不同的预计血浆浓度随机分为四组（R2、R4、R6和R8组）。在瑞芬太尼血浆和效应室浓度达平衡过程中，观察患者呼吸抑制情况、肌肉强直发生情况，记录副作用发生时瑞芬太尼的预计效应室药物浓度。记录瑞芬太尼达平衡时患者的SBP、DBP、MAP和HR。结果在瑞芬太尼达平衡过程中，R6组和R8组共有17例患者出现呼吸抑制，呼吸抑制时的瑞芬太尼预计效应室药物浓度为6.1±1.0ng/

2、ml；R8组有3例患者出现中度的肌肉强直，发生时瑞芬太尼预计效应室药物浓度平均为7.5ng/ml，所有患者均未出现重度肌肉强直；达平衡过程中，血流动力学指标无明显改变。结论单纯靶控输注瑞芬太尼时，预计血浆浓度小于4ng/ml是安全的，浓度大于4ng/ml后，呼吸抑制和肌肉强直发生率增加，但对血流动力学的影响不大。　　【关键词】瑞芬太尼；靶控输注；安全性；呼吸抑制；肌肉强直Thesafetyofremifentanilalonebytarget-controlledinfusionPengWen-ping,ZuoMing-zhang.DepartmentofAnesthesiology,Bei

3、jingHospital,Beijing100730,China【Abstract】ObjectiveToexaminethesafetyofremifentanilalonebytarget-controlledinfusion(TCI).MethodsFortypatientsundergoingelectivesurgeryundergeneralanesthesiawereenrolledinthisstudy.Thepatientswererandomizedtoreceiveremifentanilatapredictedtargetplasmaconcentrationof2n

4、g/ml,4ng/ml,6ng/mlor8ng/ml(groupR2,R4,R6,R8).Duringtheprocessofequilibrationbetweenplasmaandeffectsiteconcentrationofremifentanil,respiratorydepressionandmusclerigiditywererecorded.Andtheeffect-siteconcentrationsofremifentanilwererecordedwhenthesideeffectsoccurred.Thefollowingparameterswererecorded

5、atequilibration:systolicbloodpressure(SBP),diastolicbloodpressure(DBP),meanarterialpressure(MAP),heartrate(HR).ResultsDuringtheprocessofequilibration,therewere17patientssufferingfromrespiratorydepressionatgroupR6andR8,andtheeffect-siteconcentrationsofremifentanilwas6.1±1.0ng/mlatrespiratorydepressi

6、on.Therewere3patientssufferingfrommoderatemusclerigidityatgroupR8,andtheeffect-siteconcentrationsofremifentanilwas7.5ng/mlatmusclerigidity.Noseveremusclerigidityoccoured.Hemodynamicsdidnotchangesignificantlyduringequilibration.ConclusionItissafewhenpredictedtargetplasmaconcentrationofremifentanilis

7、lessthan4ng/ml.Theincidenceofrespiratorydepressionandmusclerigidityincreaseswhenmorethan4ng/ml,buthemodynamicsisnoteffected.【Keywords】Remifentanil;TCI;safety;respiratorydepression;musclerigidity瑞芬太尼是芬太尼家族中的