就用右美加瑞芬术中维持可以吗

joeli

小手术可以用右美加七氟醚

A-liver

可以的，苏醒时间可能晚点。另外最好有bis监测。

朱晓军

右美托咪定的镇静作用类似于自然睡眠，是可以被唤醒的，也可以因各种刺激而苏醒的，镇静能以它为主吗？右美是一种麻醉辅助药物，有一定镇静、镇痛、降压、降心率和抑制分泌物的作用，但又都不充分。全麻，全身麻醉药必不可少。单用右美和瑞芬，那是开玩笑！

新来新猪肉

要看你完成什么手术，如果止痛不够，会很麻烦

活到老学到老

，深度不够，会有术中知晓，不能想当然。，

zqx

我认为理论上是可行，但很少在实际中应用。

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

yangbb2006

不行，右美加瑞芬的维持，可引起不可逆性的心脏骤停

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。

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

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.

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

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

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？

kele00

看什么手术了，并且跟剂量大小有关系