单纯靶控输注瑞芬太尼的安全性

09 年会-临床麻醉与讨论单纯靶控输注瑞芬太尼的安全性 作者单位：卫生部医院麻醉科 ：100730 文平 左明章[摘要] 目的 观察单纯靶控输注瑞芬太尼的安全性。方法 40 例择期全麻手术患者，以血浆靶控方式输注瑞芬太尼，按不同的估计血浆浓度随机分为四组（R2、R4、R6 和 R8 组）。在瑞芬太尼血浆和效应室浓度达平衡过程中，观察患者呼吸抑制情况、肌肉强直发生情况，记录副作用发生时瑞芬太尼的估计效应室药物浓度。记录瑞芬太尼达平衡时患者的 SBP、DBP、MAP 和 HR。结果 在瑞芬太尼达平衡过程中，R6 组和 R8 组共有 17 例患者出现呼吸抑制，呼吸抑制时的瑞芬太尼估计效应室药物浓度为 6.1±1.0ng/ml；R8 组有 3 例患者出现中度的肌肉强直，发生时瑞芬太尼估计效应室药物浓度平均为 7.5ng/ml，所有患者均未出现重度肌肉强直；达平衡过程中，血流动力学指标无明显改变。 结论 单纯靶控输注瑞芬太尼时，估计血浆浓度小于 4ng/ml 是安全的，浓度大于 4ng/ml 后，呼吸抑制和肌肉强直发生率增加，但对血流动力学的影响不大。 [关键词]瑞芬太尼；靶控输注；安全性；呼吸抑制；肌肉强直The safety of remifentanil alone by target-controlled infusion Peng Wen-ping, Zuo Ming-zhang. Department of Anesthesiology, Beijing Hospital, Beijing 100730, China[Abstract] Objective To examine the safety of remifentanil alone by target-controlled infusion(TCI). Methods Forty patients undergoing elective surgery under general anesthesia were enrolled in this study. The patients were randomized to receive remifentanil at a predicted target plasma concentration of 2 ng/ml, 4 ng/ml, 6 ng/ml or 8 ng/ml (group R2, R4, R6, R8). During the process of equilibration between plasma and effect site concentration of remifentanil, respiratory depression and muscle rigidity were recorded. And the effect-site concentrations of remifentanil were recorded when the side effects occurred. The following parameters were recorded at equilibration: systolic blood pressure(SBP), diastolic blood pressure(DBP), mean arterial pressure (MAP), hear...