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The changes in hemodynamics and dose requirements in total intravenous anesthesia using propofol and buprenorphine

机译：使用异丙酚和丁丙诺啡总静脉内麻醉总静脉内麻醉的血流动力学和剂量要求的变化

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A retrospective study was performed to evaluate the changes in hemodynamics and dose requirements in total intravenous anesthesia (TIVA) using propofol and buprenorphine without (Group S: spinal surgery (3-6 h), n = 8, 28-79 Y) or with (Group A: abdominal surgery (5-10 h), n = 15, 36-83 Y) epidural anesthesia. All patients were premedicated with midazolam i.m. (2-5 mg). Anesthesia was maintained with a single dose of buprenorphine (Group S: 1.9 +/- 0.4 micrograms.kg-1, Group A: 2.0 +/- 0.5 micrograms.kg-1), propofol infusion and vecuronium with 40% oxygen in air. Group A was supplemented with continuous epidural anesthesia using 2% mepivacaine. In Group A, mean arterial pressure (MAP) and heart rate remained stable after the start of surgery. However, in Group S, 2 hours after the start of surgery MAP increased (P < 0.05) and remained elevated (P < 0.05) at higher levels than those in Group A. The maintenance dose of propofol in Group A (4.0 +/- 1.1 mg.kg-1.h-1) was significantly smaller than in Group S (6.5 +/- 0.9 mg.kg-1.h-1). In both groups, infusion rates of propofol were unchanged from 1 hour after the start to the end of surgery. Infusion rates of mepivacaine (5.2 +/- 0.9 ml.h-1) were unchanged following the increase 2 hours after the start of surgery. Awakening times were within 25 min (Group S 11.3 +/- 7.2 min vs Group A 14.7 +/- 7.3 min). There was no awareness during anesthesia in either group. The results suggest that additional continuous epidural anesthesia in TIVA would be useful to reduce propofol dose, to stabilize hemodynamic state and to obtain rapid recovery in anesthesia of long duration.
机译：进行回顾性研究以评估使用异丙酚和丁丙诺啡的总静脉内麻醉（TIVA）血流动力学和剂量要求的变化（组：脊柱手术（3-6小时），n = 8,28-79 y）或与（A组：腹部手术（5-10小时），n = 15,36-83 y）硬膜外麻醉。所有患者均受咪达唑仑原料。 （2-5毫克）。用单一剂量的丁丙诺啡（S：1.9 +/- 0.4微克，A组，A组：2.0 +/- 0.5微克，kg-1），用40％的氧气进行麻醉。 A组使用2％Mepivacaine补充了连续硬膜外麻醉。在A组中，手术开始后平均动脉压（MAP）和心率保持稳定。但是，在群体中，手术映射开始后2小时增加（P <0.05）并保持高水平升高（P <0.05），比A组含量较高。A组（4.0 +/-）的丙酚的维持剂量1.1 mg.kg-1.h-1）显着小于S（6.5 +/- 0.9 mg.kg-1.h-1）。在这两组中，从开始到手术结束后1小时，异丙酚的输注率不变。在手术开始后2小时增加后，Mepivaine（5.2 +/- 0.9 ml）的输注率不变。唤醒时间在25分钟内（S11.3 +/- 7.2 min VS组14.7 +/- 7.3分钟）。在任何一个群体中麻醉时都没有意识。结果表明，TIVA中的额外连续硬膜外麻醉是有用的，可用于减少异丙酚剂量，以稳定血液动力学状态，并在长期麻醉中获得快速恢复。

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