在重大腹部手术期间使用德克斯梅德托米丁为主导的麻醉维持策略的可行性
Cheng Ni1, Wenjie Xu1, Bing Mu1
1Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China.
Heliyon
|March 6, 2024
概括
在腹部手术期间,德克斯梅德托米丁麻醉剂有效地保持了麻醉深度. 这种策略没有显示出手术期间的意识或术后的妄想,患者报告满意度.
科学领域:
- 麻醉学 麻醉学
- 神经科学是一个神经科学.
背景情况:
- 德克斯梅托米丁提供神经保护,并可以改善术后认知功能.
- 常见的麻醉剂,如西沃弗和普罗波,可能会对认知功能产生负面影响.
- 一个德克斯梅德托米丁主导的麻醉策略需要调查潜在的益处.
研究的目的:
- 评估德克斯梅德托米丁主导的麻醉维护的性能和安全性.
- 为了确定德克斯梅德托米丁的有效输注速率 (ED50) 维持麻醉深度.
- 探索一个可行的德克斯梅德托米丁基麻醉方案用于腹部手术.
主要方法:
- 经过腹部手术的30名成年患者 (ASA I-II) 接受了使用德克斯米德米丁,雷米芬坦尼尔和罗库的麻醉.
- 迪克森上下方法确定了德克斯梅德托米丁的ED50以保持患者状态指数 (PSI) 25-40.
- 监测手术内血动力学,麻醉深度,唤醒时间,意识,妄想和患者满意度.
主要成果:
- 德克斯梅德托米丁为主导的麻醉成功维持了第三阶段麻醉深度 (PSI 25-40).
- 德克塞梅托米丁输注的ED50和ED95分别为2.298微克/千克·小时和3.765微克/千克·小时.
- 平均唤醒时间为4.8分钟;没有发生手术前意识或术后妄想.
结论:
- 在腹部手术期间,德克斯梅德托米丁主导的麻醉提供了稳定的麻醉深度.
- 德克斯梅德托米丁输液速率的ED50被确定为2.298μg/kg·h.
- 密切监测血液动力学是必不可少的,有可用于管理心和高血压的热素和酸甘油.
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