| Objective: To study the different genders on ED50(median effective concentration)and ED95(95% effective concentration)during constant remifentanil infusion of preventing the tracheal extubation period of bucking response under total intravenous anesthesia.Methods: 95 patients of undergoing the thoracic surgery with double channel catheter under the general anesthesia from December 2019 to November2020 in our hospital were selected.56 male patients were set as group A;39 female patients were set as group B.Patients in both groups were given 100% oxygen preoxygenation for 3 minutes,and anesthesia induction was performed with 1-2 μ g /kg remifentanil + 0.15-0.3mg/kg etomidate + 0.6-0.9mg/kg rocuronium.When the BIS value was lower than 60,all patients received double-lumen endotracheal intubation and continuous intravenous injection of 4-12mg/kg/h propofol + 0.1-0.3 μg / kg/min remifentanil to maintain anesthesia.Adjust the oxygen flow 2L/min.After the operation,propofol was discontinued and sputum suction was performed,and then remifentanil was adjusted to the predetermined concentration until the tube was extubated.After waiting for the patients to resume spontaneous breathing,1mg neostigmine + 0.5mg atropine was selected for antagonism.If the patient can open his eyes without stimulation,actively cooperate with the instruction to take a deep breath,make clear the tidal volume and ventilation frequency,and pull out the double-lumen tube.After extubation,the patient was given 100% oxygen through the mask for at least 5 minutes.After confirming that the vital signs were stable,the patient was transferred to the recovery room after anesthesia.The operation time,anesthesia duration,autonomous respiration recovery time,extubation time,awakening time,blood pressure and heart rate levels upon extubation,after 1min and 5min of extubation as well as ED50,ED95,OAA/S(observer’s assessment of alertness/sedation)scores,bucking response and complication rate were recorded.Results: There was no significant difference in age,weight,height and education between group An and group B(P > 0.05).There were no significant differences of the operation time,anesthesia duration,autonomous respiration recovery time,extubation time and awakening time between group A and group B(P>0.05);upon extubation,there were no significant differences of the systolic blood pressure,diastolic blood pressure and heart rate between group A and group B(P>0.05);after 1min and 5min of extubation,The systolic blood pressure and diastolic blood pressure in group A were higher than those in group B,but the heart rate in group A was lower than that in group B(P < 0.05);In group A,the systolic blood pressure and diastolic blood pressure of 1min and 5min after extubation were higher than those immediately after extubation,but the heart rate was lower than that immediately after extubation(P<0.05);the ratio of stage I and II patients in group A was lower than that of group B;the ratio of stage III and IV patients was higher than that of group B(P<0.05);complication rate between group A(8.93%)and group B(5.13%)was not significantly different(P>0.05);ED50 and ED95 in group A were 0.18μg/kg/min and 0.25μg/kg/min;ED50 and ED95 in group B were 0.13μg/kg/min and0.17μg/kg/min.OAA/S scores in group A were lower than those of group B(P<0.05).Conclusion: The different genders produce a huge effect on the tracheal extubation period of bucking response during constant remifentanil infusion;in particular,the female patients are found to have the lower hemodynamic fluctuations,fewer complications,milder bucking response and better treatment prognosis.Therefore,to achieve the same effect of suppressing cough,the males are prone to have remifentanil by comparison to the females. |
PDF Full Text Request