【www.zhangdahai.com--理工论文】
【摘要】目的 观察在相同麻醉深度下,硬膜外注入不同浓度罗哌卡因对全麻患者异丙酚及异氟醚用量的影响。方法 45例择期上腹部手术患者,根据复合硬膜外用药的不同随机分为三组:生理盐水对照组(Ⅰ组)、0.5%罗哌卡因组(Ⅱ组)、0.75%罗哌卡因组(Ⅲ组),每组15例。硬膜外阻滞平面确定后麻醉诱导以25mg/min异丙酚连续输注至患者神志消失;麻醉维持吸入异氟醚使脑电双频谱指数值(BIS)维持在50～55,硬膜外以7mL/h泵注维持。记录异丙酚用量、异氟醚呼气末浓度(ETiso)及BIS、听觉诱发电位指数(AAI)。结果 患者意识消失时异丙酚的用量:Ⅰ组(1.7±0.4)mg/g、Ⅱ组(1.2±0.3)mg/kg和Ⅲ组(1.0±0.3)mg/kg,Ⅲ组和Ⅱ组异丙酚用量比Ⅰ组明显减少(P [2] Gajraj RJ,DOi M,Mantzaridis H,et al.Comparison of bispectral EEG analysis and auditory evoked potentials for monitoring depth of anaesthesia during propofol anaesthesia[J].Br J Anaesth,1999,82:672-678.
[3] CaSati L,Femandez-Galinski S,Barrera E,et al.Isoflurane requirements dufing combined general/epidural anesdlesia for major abdominal surgery[J].Anesth Ahalg,2002,94:1331-1337.
[4] Glass Ps,Bloom M,Kearse L et al.Bispectral analysis measures Sedation and memory efiects lf propofol,midazolam,isoflurane,and alfentanil in healthy volunteers[J].Anesthesiology,1997,86:836-847.
[5] Iselin-Chavess IA,Flaison R,Sebel PS,et al.The effect lf the interaction lf propofol and alfentanil on recall,loss of consciousness,and the Bispectral Index[J].Anesth Analg,1998,87:949-955.
[6] 冯艺,孙颖,于德水,等.硬膜外阻滞的镇静作用及可能机制[J].中华麻醉学杂志,2002,22:273-275.
[7] Inagaki Y,Mashimo T,Kuzukawa A,et al.Epidural lidicaube delays arousal from isoflurane anesthesia[J].Anesth Analg,1994,79:368-372.
[8] Hodgson PS,Liu SS.Epidural ropivacaine decreases sevoflurane requirement for adequate depth of anesthesia aw measured by the Bispectral Index monitor[J].Anesthesiology,2001,94:799-780.
[9] McClellan KJ,Faulds D.Ropivacaine:an update of its use in regionalanaesthesia[J].Drugs,2000,60:1065.
