瑞芬太尼复合静脉麻醉与异氟醚静吸复合麻醉的比较  

Comparison of intravenous propofol/remifentanil with intravenous propofol plus inhalational isoflurane in general anesthesia

作　　者：张冬梅[1] 马红英 朱虹[1] 王海滨[1] 

机构地区：[1]宁夏医学院附属医院麻醉科,银川市750004 [2]宁夏中医院麻醉科,银川市750001

出　　处：《实用医学杂志》2006年第20期2418-2420,共3页The Journal of Practical Medicine

摘　　要：目的:研究瑞芬太尼复合异丙酚全凭静脉麻醉与异氟醚静吸复合全身麻醉对患者气管插管及苏醒期血流动力学变化和拔管条件的影响。方法:60例择期全麻手术的患者随机分为瑞芬太尼+异丙酚静脉麻醉(R)组和异丙酚+异氟醚静吸复合麻醉(C)组,每组30例。观察麻醉诱导、气管插管及术后恢复过程的血压、心率。记录术毕停药后病人清醒时间、拔管时间,记录病人拔管后即刻、离开手术间及术后3和24h疼痛评分(VRS)。观察恶心、呕吐等副反应。结果:麻醉诱导后气管插管1～5min内血流动力学变化幅度R组明显小于C组(P<0.05);术后清醒时间及拔管时间R组早于C组(P<0.05),并且恶心、呕吐发生率低;术后VRS评分R组高于C组。结论:瑞芬太尼复合异丙酚静脉麻醉在气管插管和麻醉苏醒期的血流动力学稳定,拔管条件优,并发症少,但应注意尽早实施术后镇痛。Objective To study the differences between intravenous propofol/remifentanil and propofol plus inhalational isoflurane in the hemodynamic changes during intratracheal intubation and recovery of consciousness in general anesthesia and to explore the options of extubation. Methods Sixty surgical patients （ASA Ⅰ～Ⅱ） were randomly divided into intravenous propofol/remifentanil group （Group R） and intravenous propofol plus inhalational isoflurane group （Group C）, with 30 for each. BP and HR were monitored during the induction of anesthesia, intratracheal intubation, and postoperative recovery. The time of eye opening and extubation following anesthetic discontinuation was recorded and VRS for pain assessment was performed right after extubation, on the leaving of the operation room, and at 3rd and 24th hour after surgery and the side effects of anesthetics such as nausea and vomiting were recorded. Results Hemodynamic changes within 1～5 minutes after the induction of anesthesia and intubation in Group R were significantly less than those in Group C （P 〈 0.05）. The recovery time from anesthesia was shorter and the intratracheal tube could be removed earlier in Group R （P 〈 0.05）. Less nausea or vomiting occurred in Group R whereas the grade of VRS in Group R was higher than that in Group C. Conclusions Anesthesia with intravenous propofol/remifentanil has stable hemodynamics and less complications during intratracheal intubation and can shorten the recovery time of unconsciousness and the duration of intubation. Postoperative analgesia should be performed as soon as possible.

关 键 词：麻醉 静脉 麻醉 吸入 二异丙酚 异氟醚 血流动力学 

分 类 号：R614[医药卫生—麻醉学]