异丙酚联合咪达唑仑消除连续硬膜外麻醉患者术中知晓40例分析(1)
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[摘要] 目的 探讨麻醉安全状态下异丙酚联合咪达唑仑消除连续硬膜外麻醉患者术中知晓的可行性及两药的合适用量。方法 选择下腹部开腹手术患者40例,行硬膜外麻醉联合靶控输注异丙酚和咪达唑仑,观察患者呼吸指标、循环指标、脑电双频指数(BIS)和警觉/镇静观察(OAA/S)评分,并对相关指标进行相关分析。结果 ①异丙酚血浆靶浓度为(1.9～2.5)μg/mL、咪达唑仑血浆靶浓度为(0.15～0.3)μg/mL,患者无知晓,且呼吸循环等生命体征平稳。BIS与OAA/S评分标准呈正相关,而且不同OAA/S评分之间的BIS值有统计学差异。②BIS、OAA/S值与异丙酚、咪达唑仑两药剂量呈负相关。③异丙酚血浆靶浓度低于(0.8～1.0)μg/mL、咪达唑仑血浆靶浓度低于(0.08～0.12)μg/mL,BIS>75时患者会出现术中知晓。结论 异丙酚联合咪达唑仑TCI能有效消除CEA患者术中知晓。
[关键词] 异丙酚;咪达唑仑;靶控输注;硬膜外麻醉;术中知晓
[中图分类号] R614[文献标识码] A[文章编号] 1673-9701(2010)02-82-03
Combination of Propofol and Midazolam for Elimination of Intraoperative Awareness:An Analysis of 40 Cases of Continuous Epidural Anesthesia
YANG FumingZHAO Weilu
Department of Anesthesiology,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China
[Abstract] Objective To investigate the feasibility of propofol and midazolam for elimination of intraoperative awareness ofcontinuous epidural anesthesia(CEA) patient and optimal dosage of the two drμgs ......
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