随机比较两种不同的雷米芬坦尼尔剂量在内镜外科手术期间对外科条件的影响
JinHyeok Jeong1, ChanWoo Park2, YoungJoon Yoon2
1Department of Otorhinolaryngology, Hanyang University Guri Hospital, Guri-Si, Gyeonggi-Do, Republic of Korea.
较高度的雷米芬坦尼尔改善了内镜鼻手术期间的外科现场条件. 这种麻醉方法导致患者的心率和心率下降,但并没有导致中风量下降.
科学领域:
- 麻醉学 麻醉学
- 手术科学 手术科学
- 心血管生理学心血管生理学
背景情况:
- 与吸入麻醉相比,propofol-remifentanil组合在内镜外科手术中提供了优越的外科现场条件.
- 优化麻醉技术对于提高手术结果和患者安全至关重要.
研究的目的:
- 在外科实地条件下比较高度 (8 ng/mL) 与低度 (4 ng/mL) 雷米芬坦尼尔的疗效.
- 评估不同度的雷米芬坦尼尔在内镜鼻手术期间对血液动力学变量的影响.
主要方法:
- 54名患者 (ASA I-II) 被随机分为高度雷米芬坦尼尔 (HR) 或低度雷米芬坦尼尔 (LR) 组.
- 手术现场的质量使用Boezaart手术现场分级尺度进行评估.
- 血液动力学参数,包括心脏输出,被非侵入性监测.
主要成果:
- 人力资源组在手术后90分钟显著改善了外科现场条件 (p=0.021).
- 在HR组中,心率在30,60和90分钟 (p<0.005) 时显著降低.
- 在HR组中,心脏输出量在输管后和30,60,90分钟 (p<0.016) 显著下降,而中风体积保持相似.
结论:
- 较高的雷米芬坦尼尔度提高了内镜鼻手术期间的外科实地质量.
- 在HR组观察到的心脏输出量的减少主要是由于心率下降,而不是中风体积.
- 在手术条件下,用优化的雷米芬坦尼尔剂量进行普罗波-雷米芬坦尼尔麻醉可以有益.
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