就用右美加瑞芬术中维持可以吗

tangzedong158

诱导完就用右美加瑞芬术中维持可以吗，大家有这样用过的吗，诱导时用了2-3MG咪坐

不给糖吃

sqhhy 发表于 2019-07-24 09:45
单纯用右美+瑞芬来维持麻醉的，是太高估右美了，是被神药右美洗脑了，我可以武断一点说，如果不是有那一点点回扣，这药很快就打回原形，用量下降80%都不止，其时这些麻醉医生心中应该有数，不要拿到台面上来说，但真以为这是神药就是太自欺欺人了。

哈哈哈 想起了当年准备写一个 关于右美不当使用引起术中知晓和苏醒延迟的 结果被老大骂了三天

来自安卓APP客户端

晴尔regitine827

sqhhy 发表于 2019-7-24 09:45
单纯用右美+瑞芬来维持麻醉的，是太高估右美了，是被神药右美洗脑了，我可以武断一点说，如果不是有那一点 ...

右美没有那么神奇的作用？是吗？好像在医疗美容麻醉用的挺好的呢？

vise

可以的，心率影响比较大，力月西量要用足点。

tabgguo

单用右美和瑞芬维持全麻，那是开玩笑！

泳橦

试过瑞+右美+七氟醚维持，术中病人体征平稳，术后没有术中知晓主诉

kele00

看什么手术了，并且跟剂量大小有关系

jerryzhjj

楼主这话都没说清楚，到底是术中只用这两个药物维持其他麻醉药物一律不用还是咋地？

jerryzhjj

这种影响因子很多的杂志的文章，内容是不是真的有临床价值打很大问号的，根本当不了一个依据

mazuidoushiliu

单纯的右美恐怕镇静深度不够吧，没有这样用过，这个方法有点奇葩，不会去尝试的

dznn2438

J Anaesthesiol Clin Pharmacol. 2014 Oct;30(4):550-4. doi: 10.4103/0970-9185.142857.
Comparison between propofol and dexmedetomidine on depth of anesthesia: A prospective randomized trial.
Chattopadhyay U1, Mallik S1, Ghosh S1, Bhattacharya S1, Bisai S1, Biswas H1.
Author information
1
Department of Anesthesiology, Burdwan Medical College, Burdwan, West Bengal, India.
Abstract
BACKGROUND AND AIMS:
Intravenous agents such as propofol are commonly used to maintain adequate depth of anesthesia. Dexmedetomidine which has an anesthetic sparing effect is being considered for maintaining intraoperative depth of anesthesia. We hypothesized to compare the effect of dexmedetomidine on depth of anesthesia with propofol and evaluated whether dexmedetomidine can be used as sole anesthetic agent in maintaining depth of anesthesia.
MATERIALS AND METHODS:
Sixty patients of ASA PS I, 18-65 years of age, scheduled for laparotomy under general anesthesia were randomly divided into two groups of 30 each. Group A received propofol 1 mg/kg bolus followed by infusion (50 mcg/kg/min) and Group B received dexmedetomidine 1 mcg/kg bolus followed by infusion (0.5 mcg/kg/h). Both the groups were administered standard general anesthesia with routine monitoring along with Bispectral index (BIS) and values were recorded at intervals of 10 min. In all patients Ramsay sedation score was recorded after extubation and they were assessed for recall of intraoperative events using Modified Brice questionnaire.
RESULTS:
Heart rate and mean arterial pressure were less in Group B than Group A. Intraoperative BIS values were significantly lower in Group B (P < 0.0001). Although sedation score was more in Group B it did not prolong recovery. No recall was found in any patient.
CONCLUSION:
Dexmedetomidine was comparable with propofol in maintaining anesthesia and it can produce better control of hemodynamics and BIS value. Thus dexmedetomidine can be used as the sole maintenance anesthetic agent.

dznn2438

有用右美作全麻维持的报告，只是不常用，不如丙泊酚便捷。

J Anaesthesiol Clin Pharmacol. 2014 Oct-Dec; 30(4): 550–554.
doi: 10.4103/0970-9185.142857
PMCID: PMC4234794
PMID: 25425783
Comparison between propofol and dexmedetomidine on depth of anesthesia: A prospective randomized trial
Uddalak Chattopadhyay, Suchismita Mallik, Sarmila Ghosh, Susmita Bhattacharya, Subrata Bisai, and Hirak Biswas
Author information Copyright and License information Disclaimer

dznn2438

理论上是可以的，有印度的作用采用右美托咪定作为全麻的镇静用药，术中一样BIS可以维持在40-60的范围。尽管认为右美托咪定引起的BIS下降，能被唤醒（上升），但在复合瑞芬的情况下，否会被手术刺激所唤醒，尚不清楚。

yangbb2006

不行，右美加瑞芬的维持，可引起不可逆性的心脏骤停

医者仁心辉

不出事啥都好   术中知晓是个不能轻视的  创新是好  但是安全第一

zqx

我认为理论上是可行，但很少在实际中应用。