【正文】
驗證實了舒芬太尼復合靶控輸注丙泊酚行MAC下鈥激光輸尿管鏡碎石術(shù)時可獲得滿意的鎮(zhèn)靜效果,血流動力學穩(wěn)定,具有可行性與安全性,可應用于臨床。濃度劑量低不宜產(chǎn)生循環(huán)呼吸的抑制,但會有輕微體動需要處理,劑量高又容易產(chǎn)生明顯的的呼吸抑制,但濃度劑量的掌握最好是根據(jù)BIS值來調(diào)節(jié),體動的原因基本上都是因為輸尿管口尋找困難,操作刺激增大引起,所以建議在復合使用舒芬太尼靶控輸注丙泊酚行MAC下行鈥激光輸尿管鏡碎石術(shù)時,先選擇較低濃度3ug/ml,再根據(jù)具體情況給予追加,既能提供適合的鎮(zhèn)靜強度,又能減少不良反應,同時減少丙泊酚的用量,縮短清醒時間。參考文獻[1] 吳江平,嚴文兵,2004,35(5):5657 .[2] 于穎群,李德馨. 監(jiān)測的麻醉處理進展. 國外醫(yī)學麻醉與復蘇分冊, 1999,20:134-137.[3] Thwaites AJ et al. Current Opinion in Anaesthesiology, 1997, 10:421.[4] ASA. Practice guidelines for sedation and analgesia by nonanesthesiologists. Anesthesiology, 2002。96(5):100417.[5] Passot S Servin F, Allary R, rt al. Target~controlled versus manually~controlled infusion of propofol for direct laryngoscopy and bronchoscopy, Anesth Analg, 2002, 94:1212~1216.[6] Gan TJ, Glass PS, Windsor A, et al. Bispectral Index monitoring allows faster emergence and improved recovery from propofol, alfentanil, and nitrous oxide anesthesia. Anesthesiology, 1997。87:80815.[7] Sleigh JW, Donovon J. Comparison of bispectral index, 95% spectral edge frequency and approximate entropy of the EEG, which charges in heart rate variability during induction of general anesthesia. Br J Anaesth, 1999, 82:666671.[8] Liu J, Singh H, White PF. Electroencephalographic bispectral index correlates with intraoperative recall and depth of propofolinduced sedation, Anesth Analg, 1997,84:185189.[9] 何紹旋,張芝芳,胥建,. 臨床麻醉學雜志,2005,20:442