瑞芬太尼联合丙泊酚用于控制性降压对胃黏膜内pH值的影响

张静; 詹春光; 陈永亮

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瑞芬太尼联合丙泊酚用于控制性降压对胃黏膜内pH值的影响

张静 , 詹春光 , 陈永亮

文章导航 > 蚌埠医学院学报 > 2008, 33 > 5: (548-551)

引用本文:

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瑞芬太尼联合丙泊酚用于控制性降压对胃黏膜内pH值的影响

1. 广东省深圳市南山区蛇口人民医院麻醉科, 518067;
2. 广东省深圳市南山区蛇口人民医院消化科, 518067

作者简介: 张静(1961-),女,副主任医师.

中图分类号: R972.4

Influence of remifentanil combined with propofol for controlled hypotension on gastric intramucosal pH

1. Department of Anesthesia, Shekou People's Hospital, Nanshan District, Shenzhen Guangdong 518067, China;
2. Department of Gastroenterology, Shekou People's Hospital, Nanshan District, Shenzhen Guangdong 518067, China
CLC number: R972.4

摘要: 目的:探讨瑞芬太尼联合丙泊酚用于控制性降压对胃黏膜内pH值的影响。方法:择期椎体骨折内固定术、脊柱侧弯矫形术、髋关节置换术等20例,随机分为观察组(瑞芬太尼联合丙泊酚用于麻醉和降压)10例和对照组(丙泊酚联合芬太尼用于麻醉,硝普钠降压)10例。观察比较两组于降压前(T₀)、降压稳定即刻(T₁)、降压10 min(T₂)、降压30 min(T₃)、降压1 h(T₄)、停降压后10 min(T₅)、停降压后30 min(T₆)6个时间点的平均动脉压(MAP)、心率(HR)、中心静脉压(CVP)、胃黏膜内二氧化碳分压(PgCO₂)、动脉血气,并推算出胃pH值变化情况。结果:观察组PgCO₂值T₂、T₃、T₄明显高于T₀、T₁时点(P<0.01);pH值T₃、T₄明显低于T₀、T₁(P<0.01),PgCO₂在降压1 h时由降压前的(T₀)46.5 mmHg升至70.8 mmHg。停降压后30 min(T₆)回升至正常。对照组PgCO₂值,在T₂、T₃、T₄、T₅较T₀升高(P<0.01);pH值T₂、T₃、T₄、T₅明显低于T₀时点(P<0.01),PgCO₂由降压前(T₀)47 mmHg升至79mmHg(T₄),停止降压30 min(T₆)恢复正常。观察组PgCO₂在T₂、T₃、T₄时点显著低于对照组(P<0.01);pH值在T₃和T₅高于对照组(P<0.01)。结论:瑞芬太尼联合丙泊酚用于控制性降压可以引起一过性胃肠道微循环障碍,但较传统的控制性降压药硝普钠对胃肠道微循环影响小,且停药后10 min恢复正常。
- 丙泊酚 /
- 瑞芬太尼 /
- 胃pH值 /
- 控制性降压
Abstract: Objective: To discuss the influence of remifentanil combined with propofol for controlling hypotension on gastric intramucosal pH(pHi).Methods: Twenty patients undergoing elective vertebral fracture internal fixation,femoral shaft fracture internal fixation or hip replacement patients were randomly divided into two groups.The test group(n=10) received remifentanil and propofol for anesthesia and lowering blood pressure,and control group(n=10) received fentanyl and propofol for anesthesia and sodium nitroprusside(SNP) for lowering blood pressure.The MAP,SBP,DBP,HR,CVP,PgCO₂,arterial blood gas and pHi at the time point T₀(before the blood pressure lowering),T₁(immediate relief and stability),T₂(blood pressure dropping 10 min),T₃(blood pressure dropping 30 min),T₄(hypotension 1 h),T₅(stopping blood pressure dropping 10 min) and T₆(stopping blood pressure dropping 30 min) were determined and compared between the both groups.Results: In the test group,the value of PgCO₂ at the time point T₂,T₃,T₄ were obviously higher than that at T₀ and T₁(P<0.05);pHi at T₃ and T₄ were lower than that at T₀ and T₁(P<0.05).The value of PgCO₂ increased from 46.5 mmHg(T₀) to 70.8 mmHg(T₄),and recovered at T₆.In control group,the value of PgCO₂ at T₂,T₃,T₄ and T₅ were higher than that at T₀ and T₁(P<0.05);the value of pHi at T₂,T₃,T₄ and T₅ were obviously lower than that at T₀(P<0.01).The value of PgCO₂ increased from 47 mmHg(T₀) to 79 mmHg(T₄),and recovered at T₆.The value of PgCO₂ at T₂,T₃ and T₄ in the test group were obviously lower than that in control group(P<0.01),whereas the pHi at T₃ and T₅ were higher than that in control group(P<0.01).Conclusions: The transient gastrointestinal microcirculation disturbance can be found in controlling hypotension by remifentanil and propofol,but it is obvious smaller than by the traditional medicine SNP,and can be recovered in 10 min after stopping the medicine.
- propofol /
- remifentanil /
- gastric intramucosal pH /
- controlled hypotension

[1]	徐兰华 , 王梅 . 瑞芬太尼控制性降压对非骨水泥型全髋关节置换术患者脑氧代谢的影响. 蚌埠医学院学报, 2012, 36(3): 320-322.
[2]	赵琛 , 李应杰 . 瑞芬太尼复合丙泊酚在无痛胃镜检查中的应用. 蚌埠医学院学报, 2014, 39(8): 1080-1081.
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[4]	李晓立 , 李晓红 , 文公堂 , 王南海 , 金钟 . 靶控输注丙泊酚与联合瑞芬太尼用于无痛人工流产术的临床效果比较. 蚌埠医学院学报, 2008, 33(4): 405-408.
[5]	陆松虹 , 徐晖 , 潘松 , 张景俊 , 李勇 . 不同剂量瑞芬太尼对全麻患者丙泊酚靶控输注诱导剂量及时间的影响. 蚌埠医学院学报, 2012, 36(3): 277-279.
[6]	李克寒 , 杨惠敏 , 郭丹 . 瑞芬太尼或不同剂量地佐辛全麻诱导期喉罩置入对丙泊酚半数有效血浆靶浓度的影响. 蚌埠医学院学报, 2016, 41(10): 1299-1301,1305. doi: 10.13898/j.cnki.issn.1000-2200.2016.10.013
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[10]	刘刚 , 陈兰仁 . 脑膜瘤术中瑞芬太尼联合异氟烷控制性降压效果观察. 蚌埠医学院学报, 2008, 33(4): 411-413.
[11]	邵兰 . 丙泊酚和芬太尼不同配伍剂量用于人工流产术麻醉效果比较. 蚌埠医学院学报, 2005, 30(1): 59-60.
[12]	张庆文 , 马明 . 丙泊酚配伍芬太尼、氧化亚氮用于人工流产术麻醉的对比观察. 蚌埠医学院学报, 2005, 30(4): 311-313.
[13]	邱庆荣 . 咪达唑仑联合芬太尼、丙泊酚用于人工流产术的麻醉处理. 蚌埠医学院学报, 2010, 35(10): 1027-1029.
[14]	郭全周 . 地佐辛与芬太尼联合靶控输注丙泊酚用于无痛ERCP的对比研究. 蚌埠医学院学报, 2014, 39(11): 1538-1539.
[15]	朱姝颖 . 舒芬太尼联合丙泊酚全凭静脉麻醉用于胸科手术的临床观察. 蚌埠医学院学报, 2015, 40(5): 619-621. doi: 10.13898/j.cnki.issn.1000-2200.2015.05.019
[16]	陆松虹 , 王忠云 . 雷米芬太尼和芬太尼分别联合丙泊酚诱导麻醉对气管插管患者血流动力学的影响. 蚌埠医学院学报, 2007, 32(2): 166-167.
[17]	杨清峰 , 张旭 , 江泳 , 周磊 , 张爽 . 小剂量丙泊酚联合舒芬太尼静脉麻醉在食管静脉曲张套扎术中的应用. 蚌埠医学院学报, 2013, 37(1): 48-50,53.
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[19]	徐晖 , 陆松虹 , 张景俊 , 潘松 , 程亮 , 吴鸿浩 . 权重配方法研究咪达唑仑、芬太尼和丙泊酚联合诱导对血流动力学的影响. 蚌埠医学院学报, 2019, 44(5): 620-622, 626. doi: 10.13898/j.cnki.issn.1000-2200.2019.05.016
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瑞芬太尼联合丙泊酚用于控制性降压对胃黏膜内pH值的影响

作者简介: 张静(1961-),女,副主任医师.

1. 广东省深圳市南山区蛇口人民医院麻醉科, 518067;
2. 广东省深圳市南山区蛇口人民医院消化科, 518067

收稿日期: 2008-06-20

关键词:

摘要: 目的:探讨瑞芬太尼联合丙泊酚用于控制性降压对胃黏膜内pH值的影响。方法:择期椎体骨折内固定术、脊柱侧弯矫形术、髋关节置换术等20例,随机分为观察组(瑞芬太尼联合丙泊酚用于麻醉和降压)10例和对照组(丙泊酚联合芬太尼用于麻醉,硝普钠降压)10例。观察比较两组于降压前(T₀)、降压稳定即刻(T₁)、降压10 min(T₂)、降压30 min(T₃)、降压1 h(T₄)、停降压后10 min(T₅)、停降压后30 min(T₆)6个时间点的平均动脉压(MAP)、心率(HR)、中心静脉压(CVP)、胃黏膜内二氧化碳分压(PgCO₂)、动脉血气,并推算出胃pH值变化情况。结果:观察组PgCO₂值T₂、T₃、T₄明显高于T₀、T₁时点(P<0.01);pH值T₃、T₄明显低于T₀、T₁(P<0.01),PgCO₂在降压1 h时由降压前的(T₀)46.5 mmHg升至70.8 mmHg。停降压后30 min(T₆)回升至正常。对照组PgCO₂值,在T₂、T₃、T₄、T₅较T₀升高(P<0.01);pH值T₂、T₃、T₄、T₅明显低于T₀时点(P<0.01),PgCO₂由降压前(T₀)47 mmHg升至79mmHg(T₄),停止降压30 min(T₆)恢复正常。观察组PgCO₂在T₂、T₃、T₄时点显著低于对照组(P<0.01);pH值在T₃和T₅高于对照组(P<0.01)。结论:瑞芬太尼联合丙泊酚用于控制性降压可以引起一过性胃肠道微循环障碍,但较传统的控制性降压药硝普钠对胃肠道微循环影响小,且停药后10 min恢复正常。

English Abstract

Influence of remifentanil combined with propofol for controlled hypotension on gastric intramucosal pH

1. Department of Anesthesia, Shekou People's Hospital, Nanshan District, Shenzhen Guangdong 518067, China;
2. Department of Gastroenterology, Shekou People's Hospital, Nanshan District, Shenzhen Guangdong 518067, China

Received Date: 2008-06-20

Abstract: Objective: To discuss the influence of remifentanil combined with propofol for controlling hypotension on gastric intramucosal pH(pHi).Methods: Twenty patients undergoing elective vertebral fracture internal fixation,femoral shaft fracture internal fixation or hip replacement patients were randomly divided into two groups.The test group(n=10) received remifentanil and propofol for anesthesia and lowering blood pressure,and control group(n=10) received fentanyl and propofol for anesthesia and sodium nitroprusside(SNP) for lowering blood pressure.The MAP,SBP,DBP,HR,CVP,PgCO₂,arterial blood gas and pHi at the time point T₀(before the blood pressure lowering),T₁(immediate relief and stability),T₂(blood pressure dropping 10 min),T₃(blood pressure dropping 30 min),T₄(hypotension 1 h),T₅(stopping blood pressure dropping 10 min) and T₆(stopping blood pressure dropping 30 min) were determined and compared between the both groups.Results: In the test group,the value of PgCO₂ at the time point T₂,T₃,T₄ were obviously higher than that at T₀ and T₁(P<0.05);pHi at T₃ and T₄ were lower than that at T₀ and T₁(P<0.05).The value of PgCO₂ increased from 46.5 mmHg(T₀) to 70.8 mmHg(T₄),and recovered at T₆.In control group,the value of PgCO₂ at T₂,T₃,T₄ and T₅ were higher than that at T₀ and T₁(P<0.05);the value of pHi at T₂,T₃,T₄ and T₅ were obviously lower than that at T₀(P<0.01).The value of PgCO₂ increased from 47 mmHg(T₀) to 79 mmHg(T₄),and recovered at T₆.The value of PgCO₂ at T₂,T₃ and T₄ in the test group were obviously lower than that in control group(P<0.01),whereas the pHi at T₃ and T₅ were higher than that in control group(P<0.01).Conclusions: The transient gastrointestinal microcirculation disturbance can be found in controlling hypotension by remifentanil and propofol,but it is obvious smaller than by the traditional medicine SNP,and can be recovered in 10 min after stopping the medicine.