丙泊酚复合瑞芬太尼靶控静脉麻醉与静吸复合麻醉的临床观察  

Observe of anesthesia with target-controlled infusion of propofol-remifenentanil versus isoflurane.

作　　者：宋甲[1] 宋玲[2] 万辉勤 

机构地区：[1]广东省东莞市人民医院麻醉科,广东东莞523018 [2]宜春学院,江西宜春336000 [3]江西省宜春消防支队卫生队,江西宜春336000

出　　处：《宜春学院学报》2006年第4期91-92,共2页Journal of Yichun University

摘　　要：目的:比较丙泊酚复合瑞芬太尼靶控静脉麻醉与静吸复合麻醉的诱导和术后苏醒过程.方法:选腹腔镜胆囊切除术40例,ASA I—II级,15—66岁,随机分为静吸复合麻醉(C)组,丙泊酚瑞芬太尼靶控(R)组,每组20例,观察麻醉诱导,气管插管时的血压、心率,术毕停药后病人自主呼吸恢复时间,呼之睁眼时间,拔管时间,离开手术室时间,观察恶心、呕吐情况.结果:C组诱导时的收缩压低于R组,低血压者多于R组,插管反应发生率R组低于C组;二组病人术后自主呼吸恢复时间,呼之睁眼时间,拔管时间差异无显著性,恶心、呕吐发生率差异无显著性.结论:与静吸复合麻醉相比,异丙酚瑞芬太尼靶控输注麻醉诱导更平稳.Objective To compare the induction of and energenee from anesthesia with target- controlled infusion （TCI） of propofol - remifentanil and isoflurane inhalation. Methods Forty ASA Ⅰ-Ⅱ patients aged 15 -65 yr undergoing laparaseopie eholeeysleetomy were randomly divided into two group of 20 patients： groupC and R . In group C anesthesia was induced with propofol 1.5 - 2. 0mg/ kg. Fentanyl 1.5 - 2. 0ug/kg and veeuronium 0. lmg/kg maintained with 0. 8 % - 2. 5 % isofluraqne. In group R anesthesia was in- duced and maintained with TCI propofol - remifentanil which was stopped at the end of operation. The target plasma concentration of propofol was set at3 ug/ml and remifentanil at 7ng/ml. SBP, HR, ECG, SPO2, PETCO2, and entidal isoflurane concentration were monitored during anesthesia. The following were recorded and compared among the 2 groups ： （ 1 ） the change in SBP and HR during induction and tracheal in tubation. （2） Recovery of spontraneous breathing and orientation after termination of anesthesia （3） OAAS scores after operation. Results （ 1 ） During induction SBP was significantly lower in group C than in group R , and more patients dereloped hypotension （SBP 〈90mmHg） in group C （2） The duration from termination of anesthesia to fullreeovery of sponlaneous breathing, eye opening at request and tracheal extubation were similar among the two groups （ 3 ） The OAAS sore （5 = fully conscious. 1 = deep sleep ） at extnhations and disehange from Operation Room was significantly higher in group R than in group C. （4） The incidence of postoperative nausea and vomiting was similar among the two group. Conclusion Induction of anesthesia with TIC of propofol - remifentanil is hemodynamieally stablest among the two group. Recovery from anesthesia with TCI propofol - remifentanil is faster than that with inhalation anesthesia.

关 键 词：二异丙酚 哌啶类 药物释放系统 静脉内麻醉 麻醉 吸入 

分 类 号：R614[医药卫生—麻醉学]