丙泊酚复合瑞芬太尼在阻塞性睡眠呼吸障碍综合征手术麻醉中的应用  

Effect of Propofol combined with remifentanil anesthesia on patients undergoing UPPP

作　　者：徐飞[1] 包天秀[1] 沈通朝[1] 

机构地区：[1]扬州市第一人民医院麻醉科,江苏扬州225001

出　　处：《山东大学耳鼻喉眼学报》2006年第6期533-535,共3页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的：评价丙泊酚复合瑞芬太尼用于阻塞性睡眠呼吸障碍综合征腭咽成形术麻醉的效果。方法：将择期行腭咽成形术阻塞性睡眠呼吸障碍综合征的患者40例，随机分为两组，瑞芬太尼组（R组n=20）和芬太尼组（F组n=20），均全麻气管内插管，R组瑞芬太尼1．5—2．0μg／kg诱导，0．3～0．6μg／kg·min维持麻醉；F组芬太尼2．0～3．0μg/kg诱导，气管插管后追加8．0～10．0μg/kg维持麻醉，余麻醉用药俩组相同。监测诱导前、诱导时、插管后、术毕MAP、HR、SPO2、术毕自主呼吸恢复时间、苏醒时间、拔管时间和苏醒质量。结果：两组患者诱导后MAP较诱导前均明显下降（P＜0．05），R组同时伴有心率减慢（P＜0．05），插管后及苏醒阶段R组MAP及HR均较F组低（P＜0．05）；术后自主呼吸恢复时间、苏醒时间及拔管时间，R组明显早于F组（P＜0．05）。结论：丙泊酚复合瑞芬太尼麻醉可控性强，能有效抑制术中心血管不良反应，苏醒质量优良，更适合阻塞性睡眠呼吸障碍综合征手术的麻醉。Objective： To observe the effect of propofol combined with remifentanil anesthesia for uvulopalalopharyngoplasty （UPPP）. Methods： Forty patients with obstructive sleep apnea hypopnea syndrome （OSAHS） were randomly divided into two groups： Remifentanil group（R group, n = 20） and Fentany group （ F group, n = 20）. All patients were given general anesthesia with tracheal intubation. In R group, 1.5-2μg/kg remifentanil was given for induction, and then 0.3-0.6μg/kg Remifentanil per minute for maintenance. In F group, 2-3μg/kg Fentanyl was given for induction, and then 8-10 μg/kg Fentanyl for maintenance. ECG, MAP, HR, SPO2, the time that recovering of spontaneous breath and of extubation were monitored. Results： MAP was significantly decreased in the two groups （ P 〈0.05）, but HR were slowly down （ P 〈 0.05） in R group. MAP and HR in R group were lower than those in F group. The recovering of spontaneous breath and of extubation in R group was earlier than that in F group. Conclusion： Propofol combined with remifentanil anesthesia is better for patients undergoing UPPP.

关 键 词：丙泊酚 瑞芬太尼 芬太尼 阻塞性睡眠呼吸障碍综合征 腭咽成形术 

分 类 号：R766.7[医药卫生—耳鼻咽喉科]