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| 闭环靶控输注静脉全麻中持续泵注艾司洛尔对麻醉药用量和术后疼痛的影响 |
| Effect of continuous infusion of esmolol on the dose of narcotic drugs and postoperative pain and postoperative nausea and vomiting in closed-loop target controlled intravenous anesthetic system |
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| DOI：10.12089/jca.2018.08.006 |
| 中文关键词: 艾司洛尔 瑞芬太尼 丙泊酚 术后疼痛 |
| 英文关键词: Esmolol Remifentanil Propofol Postoperative pain |
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| 中文摘要: |
目的 探讨闭环靶控输注静脉全麻过程中持续泵注艾司洛尔对麻醉药用量及术后疼痛的影响。
方法 选择择期行腹腔镜胆囊切除手术的患者60例,男29例,女31例,年龄25～45岁,ASA Ⅰ或Ⅱ级。随机分为艾司洛尔组(E组)和生理盐水组(C组)。E组麻醉诱导前5 min静注艾司洛尔0.5 mg/kg,麻醉维持过程中持续泵注艾司洛尔50 μg·kg-1·min-1直至拔管,C组输注等量生理盐水。两组均采用闭环靶控输注系统进行麻醉诱导和维持。记录丙泊酚和瑞芬太尼用量、术后入PACU时、术后30 min和术后1 h的VAS疼痛评分以及术后恶心呕吐发生情况。
结果 诱导时E组丙泊酚用量为(87.9±13.8) mg,明显少于C组的(110.2±20.4) mg(P<0.05)。麻醉维持时E组瑞芬太尼用量为(606.8±204.4) μg,明显少于C组的(870.0±208.2) μg(P<0.05)。两组丙泊酚总用量差异无统计学意义。E组术后30 min和术后1 h的VAS疼痛评分明显低于C组(P<0.05)。两组术后恶心呕吐发生率差异无统计学意义。
结论 闭环靶控输注静脉全麻中持续泵注艾司洛尔能减少麻醉镇痛药用量,减轻术后早期疼痛程度。 |
| 英文摘要: |
Objective To investigate the effects of continuous infusion of esmolol on the amount of narcotic drugs and postoperative pain and postoperative nausea and vomiting (PONV) in closed-loop target controlled intravenous anesthetic system.
Methods Sixty patients, scheduled for elective laparoscopic cholecystectomy, 29 males and 31 females, aged 25-45 years, ASA physical status Ⅰ or Ⅱ, were enrolled in this observational trial. Patients were randomly divided into esmolol group (group E) and saline group (group C). Group E was given intravenous infusion of esmolol 0.5 mg/kg 5 min before induction. The anesthesia maintenance procedure continued with esmolol 50 μg·kg-1·min-1 being pumped until extubation. Group C was treated with the same dose of saline. Both groups were treated with closed-loop target controlled intravenous anesthetic system for anesthesia induction and maintenance. The dose of propofol and remifentanil were recorded. Moreover, postoperative pain and postoperative nausea and vomiting frequency were also recorded.
Results The dosage of propofol for induction in group E was less than that in group C [(87.9 ± 13.8) mg vs (110.2 ± 20.4) mg, P<0.05]. The dosage of remifentanil for the whole anesthetic procedure was significantly less in group E than that in group C [(606.8 ± 204.4) μg vs (870.0 ± 208.2) μg, P < 0.05]. VAS score was lower in group E than in group C at postoperative 30 min and 1 hour (P < 0.05). Total usage of propofol was similar in both groups. The occurrence rate of postoperative nausea and vomiting had no significant difference between the two groups.
Conclusion In general anesthesia, the usage of closed-loop target controlled system combined with continuous infusion of esmolol can reduce the amount of anesthetic, and reduce the severity of acute postoperative pain. |
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