發(fā)布時(shí)間：2018-03-04 19:06

  本文選題：右美托咪啶　切入點(diǎn)：瑞芬太尼　出處：《青島大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:評(píng)價(jià)右美托咪啶對(duì)瑞芬太尼抑制下腹部手術(shù)患者體動(dòng)反應(yīng)的半數(shù)有效效應(yīng)室靶濃度(EC50)的影響.方法:擇期行子宮全切術(shù)或子宮肌瘤剜除術(shù)患者,ASA分級(jí)I或II級(jí),年齡20-60歲,體重指數(shù)20-30kg/m2,采用隨機(jī)數(shù)字表法,將患者隨機(jī)分為2組,D組靜脈輸注右美托咪啶0.6μg/kg,時(shí)間設(shè)定為10min,C組給予生理鹽水,停藥5min時(shí)開始靶控輸注異丙酚,血漿靶濃度3.0μg/ml,輸注12min時(shí),2組開始靶控輸注瑞芬太尼,第1例的效應(yīng)室靶濃度為4.5ng/ml,輸注瑞芬太尼3min時(shí)置入喉罩,保留自主呼吸,待瑞芬太尼達(dá)到目標(biāo)靶濃度后開始手術(shù)。根據(jù)切皮時(shí)是否發(fā)生體動(dòng)反應(yīng)確定下一例患者瑞芬太尼的靶濃度,相鄰靶濃度比值為1.2.采用序貫法計(jì)算瑞芬太尼抑制切皮時(shí)體動(dòng)反應(yīng)的EC50及其95%可信區(qū)間(95%CI)。結(jié)果:D組和C組樣本數(shù)分別為18和20.瑞芬太尼抑制切皮時(shí)體動(dòng)反應(yīng)的EC50分別為1.23 ng/ml(95%CI 1.16-1.30 ng/ml)和1.52 ng/ml(95%CI 1.44-1.60 ng/ml),D組比C組降低19%(P0.05。結(jié)論:術(shù)前靜脈注射右美托咪啶0.6μg/kg可降低瑞芬太尼抑制下腹部手術(shù)患者切皮時(shí)體動(dòng)反應(yīng)的EC50,大約降低19%。
[Abstract]:Objective: to evaluate the effect of dexmetidine on the inhibitory effect of remifentanil on body motility in patients undergoing lower abdominal surgery. Methods: selective hysterectomy or enucleation of uterine myoma was performed in patients with ASA grade I or II. Age 20-60 years, body mass index (BMI) 20-30kg / m2. Patients were randomly divided into two groups: group D: dexmetidine 0.6 渭 g / kg, group C was given normal saline for 10 min, and propofol was administered by target control at 5 min after withdrawal. The plasma target concentration was 3.0 渭 g / ml. The target controlled remifentanil was given to the two groups at 12 min after infusion. The target concentration of the first group was 4.5 ng / ml. Remifentanil was implanted into the laryngeal mask at 3 min to retain spontaneous respiration. Surgery begins when remifentanil reaches its target concentration. The target concentration of remifentanil in the next patient is determined on the basis of whether the volume response occurs during the skin incision. The ratio of adjacent target concentration was 1.2. The EC50 and its 95% confidence interval of remifentanil on the inhibition of body motility during skin incision were calculated by sequential method. Results the samples of group D and group C were 18 and 20 respectively. The EC50 of remifentanil inhibited the somatic response during skin incision. 1.23 ng/ml(95%CI 1.16-1.30 ng / ml) and 1.52 ng/ml(95%CI 1.44-1.60 ng / ml group D decreased 19g / ml compared with C group (P 0.05). Conclusion: preoperative intravenous injection of dexmetidine 0.6 渭 g / kg can reduce EC50 of remifentanil inhibition in patients undergoing lower abdominal surgery, and decrease by 19.5%.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R614

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 李云;張野;左友梅;孔令鎖;胡憲文;翁立軍;;右美托咪定對(duì)瑞芬太尼復(fù)合丙泊酚靶控輸注全麻的影響[J];臨床麻醉學(xué)雜志;2012年05期

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