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The Efficacy and Safety of Targed-controlled Infusions of Remifentanil and Predictive Performance of Targed-controlled Infusions System during Thoracic Surgery

Author: ZhangJiaQiang
Tutor: XingYuYing
School: Hebei Medical University
Course: Anesthesiology
Keywords: Remifentanil Target-controlled infusion Feasibility study Evaluation System Performance Blood concentration High performance liquid chromatography - ultraviolet detector
CLC: R614
Type: Master's thesis
Year: 2005
Downloads: 73
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Abstract

Objective: To compare three different target concentrations of remifentanil and propofol target-controlled infusion (TCI) in thoracic surgery patients in the application of safety and effectiveness , explore the safe and effective target concentration of remifentanil and to evaluate the performance of the three target concentration infusion under Swiss fentanyl TCI system , and provide a reference for clinical application . Methods: 45 cases of elective thoracic surgery patients , the ASAI, Ⅱ level . , Age 40 to 65 years old , weighing 30 ~~ 75kg . Different randomly divided into three groups according to the concentration of remifentanil : 4ng · ml ^{-1 (R4 group ) , 6 ng · ml ^{-1 ( R6 ), 8 ng · ml ^{-1 ( R8 group ) . 30 minutes before anesthesia given midazolam 0.05mg · kg ^{-1 and atropine 0.5mg . Continuous monitoring of radial artery blood pressure , ECG , pulse oximetry (SPO2 ) , end-tidal partial pressure of carbon dioxide (P-_ET CO ₂), Bispectral Index (BIS) and each component of heart rate variability . Anesthesia was induced three remifentanil target concentration were 4ng · ml ^{-1 ( R4 group ) , 6 ng · ml ^{-1 (R6 group ) , 8 ng · ml ^{-1 (R8 groups ) , the propofol the target concentration are 3μg · ml ^{-1 open simultaneously remifentanil and propofol TCI infusion pump , until the patient lost consciousness after the intravenous injection of vecuronium 0.1 mg · kg ^{-1 , endotracheal intubation, intubation success , connection anesthesia ventilator to maintain ventilation to maintain end-expiratory P-_ET CO ₂ 30 ~ 40mmHg. Anesthesia was maintained with remifentanil target concentration , three groups remain unchanged , and adjust the target concentration of propofol to maintain BIS values ??between 45 ^{5 5 , intermittent injection of vecuronium to maintain muscle relaxants . Until the end of surgery to suture skin is completed , immediately stop the infusion of remifentanil and propofol . Ming 2mg surgery given neostigmine and atropine 1mg antagonize residual muscle relaxant effect , the patient fully recovered spontaneous breathing ( respiratory rate gt ; 10 times / min}}}}}}}}}}

The Efficacy and Safety of Targed-controlled Infusions of Remifentanil and Predictive Performance of Targed-controlled Infusions System during Thoracic Surgery

Abstract

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