【摘要】 目的探究老年脊柱外科手术中,复合丙泊酚持续泵注舒芬太尼的适宜临床剂量。方法择期老年脊柱外科手术患者60例,随机平均分为3组,术中使用丙泊酚(4.0 mg·kg-1·h-1)维持麻醉,同时分别持续静脉泵注舒芬太尼0.1μg·kg-1·h-1(组Ⅰ)、0.15μg·kg-1·h-1(组Ⅱ)和0.2μg·kg-1·h-1(组Ⅲ)。术中持续监测患者的BP、HR、SPO2和ECG;术闭记录患者的清醒时间、拔管时间和定向力恢复时间,并观察期间各类不良反应的发生情况。结果与组Ⅱ和组Ⅲ患者术中轻微波动的心血管反应不同,组Ⅰ中有75%的患者出现明显血压增高和心率增快反应,需要追加吸入七氟烷给与纠正。与组Ⅱ比较,组Ⅲ患者术后拔管时间、清醒时间和定向力恢复时间分别延长42.5%、52.6%和49.8%。组Ⅰ患者术后躁动的发生率为20.8%,而组Ⅰ和组Ⅲ患者术后恶心呕吐的发生率高达41.7%和65.2%。结论对于老年脊柱外科手术,作为一种安全、高效的麻醉方案,复合丙泊酚麻醉持续泵注舒芬太尼的适宜剂量为0.15μg·kg-1·h-1。更多还原

【Abstract】 Objective: To investigate the optimal dose of sufentanil combined with intravenous administration of propofol to perform general anesthesia for spine surgery in the elderly patients.Methods: 75 patients scheduled for elective spine surgery under general anesthesia were randomly and equally divided into 3 groups.During the propofol-based anesthesia(4.0 mg·kg-1·h-1),they received continuous administration of sufentanil 0.1μg·kg-1·h-1(GroupⅠ),0.15μg·kg-1·h-1(GroupⅡ) and 0.2μg·kg-1·h-1(Group Ⅲ) respectively.BP,HR,SpO2,and ECG were monitored continuously during the operation.While the extubation time,awakening time,and orientation-recovery time were recorded at the end of surgery,all adverse responses were also observed.Results: Different from the hemodynamically-stable state in GroupⅡand GroupⅢ,75% patients in GroupⅠshowed the increases in BP and HR,which could be corrected by inhalation of sevoflurane.Compared with GroupⅡ,the extubation time,awakening time,and orientation recovery time in Group Ⅲ prolonged 42.05%,52.6% and 49.8% respectively.20.8% patients in GroupⅠshowed postoperative agitation,while the occurrence of postoperative nausea and vomiting were 41.7% and 65.2% in GroupⅡ and Group Ⅲ.Conclusions: As a safe and efficient anesthesia program for spine surgery in the elderly patients,the optimal dosage of sufentanil added in propofol-based anesthesia is 0.15 μg·kg-1·h-1.更多还原