https://medcraveonline.com/JACCOA/anesthetic-and-hemodynamic-management-in-patients-with-different-approaches-for-multiple-neurological-pathologies-case-report.html

F. Ariza, Gustavo Cruz, D. Castaño, I. Quintero, Laura Suárez, Mauricio Burbano, Einar Burbano Burbano
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摘要

目的:评价瑞芬太尼1.0、2.0和2.5 ng三种不同效应位点浓度的影响。Ml-1]对地氟醚或七氟醚平衡麻醉后拔管期间咳嗽、心率和收缩压的影响。设计:双盲对照试验。地点:手术室。患者:接受选择性手术的ASA I-II级成人(n=451)。干预措施:受试者被随机分配维持瑞芬太尼效应部位浓度在1.0、2.0和2.5 ng。在接受瑞芬太尼和七氟醚与地氟醚平衡全身麻醉后,靶控输注系统中的Ml-1。测量方法:在睁眼、拔气管和术后2.5分钟记录咳嗽严重程度(采用四点强度量表)、心率和收缩压。主要结果:瑞芬太尼2.0、2.5 ng组咳嗽均明显减轻。与1.0 ng相比,Ml-1在睁眼、拔管时和拔管后2.5分钟。地氟醚在气管拔管时的风险比(95% CI)分别为0.35(0.23-0.53)和0.33 (0.21-0.52);七氟醚分别为0.50(0.35-0.73)和0.45(0.30-0.73)。P < 0.001]。在这些时间点上,任何研究组的心率或收缩压值都没有显著差异。结论:在七氟醚或地氟醚平衡全身麻醉下选择手术的成人患者中,维持瑞芬太尼效应部位浓度在2.0-2.5ng。Ml-1显著降低咳嗽的风险,但对气管拔管时的血流动力学反应没有作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
https://medcraveonline.com/JACCOA/anesthetic-and-hemodynamic-management-in-patients-with-different-approaches-for-multiple-neurological-pathologies-case-report.html
Purpose: To evaluate the impact of three different effect-site concentrations of remifentanil [1.0, 2.0 and 2.5 ng.ml-1] on cough, heart rate and systolic blood pressure during extubation after balanced anesthesia with desflurane or sevoflurane. Design: Double-blinded controlled trial. Setting: Operating room. Patients: ASA I-II adults (n=451) who underwent elective procedures. Interventions: Subjects were randomly assigned to maintain remifentanil effect-site concentrations at 1.0, 2.0 and 2.5 ng.ml-1 by a target control infusion system after receiving balanced general anesthesia with remifentanil and sevoflurane vs. desflurane. Measurements: Cough severity (using a four-point intensity scale), heart rate and systolic blood pressure were registered during eye opening, tracheal extubation and 2.5 minutes after. Main Results: Cough was significantly reduced in all groups of remifentanil at 2.0 and 2.5 ng.ml-1 during eye opening, tracheal extubation and 2.5 minutes after, when compared with 1.0 ng.ml-1 [Risk ratio (95% CI) at tracheal extubation 0.35 (0.23-0.53) and 0.33 (0.21-0.52) for desflurane; 0.50 (0.35-0.73) and 0.45 (0.30-0.73) for sevoflurane, respectively. P < 0.001]. There were no significant differences on heart rate or systolic blood pressure values at these time points for any of the studied groups. Conclusion: In adult patients of elective procedures under balanced general anesthesia with sevoflurane or desflurane, maintaining a remifentanil effect-site concentration at 2.0-2.5ng.ml-1 significantly reduce the risk of cough but not hemodynamic responses during tracheal extubation.
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