雷米芬太尼对肝硬化后脾切除术患者苏醒的影响  

Effect of remifentanil on anesthesia emergency in patients with hepatic cirrhosis undergoing lienectomy

作　　者：廖建梅[1] 王佳[1] 陈家华[1] 

机构地区：[1]南京市第二医院麻醉科,210003

出　　处：《临床麻醉学杂志》2008年第11期945-946,共2页Journal of Clinical Anesthesiology

摘　　要：目的观察雷米芬太尼在肝硬化患者脾切除手术的应用中对其麻醉苏醒的影响。方法选择肝炎后肝硬化合并脾功能亢进患者40例,随机均分为雷米芬太尼组(Ⅰ组)和芬太尼组(Ⅱ组)。分别以雷米芬太尼和芬太尼作为麻醉镇痛药,观察两组手术结束停药后患者呼之睁眼时间、自主呼吸恢复时间、拔管时间、定向力恢复时间,观察患者拔管后即刻、拔管后30min和1h的意识状态(OAA/S评分)。结果Ⅰ组患者的呼之睁眼时间、自主呼吸恢复时间、拔管时间、定向力恢复时间均短于Ⅱ组(P<0.05)。结论雷米芬太尼用于肝功能不全的患者安全、有效,而且代谢快,有利于术后恢复,是一种更理想的麻醉镇痛药。Objective To investigate the effect of remifentanil on the anesthesia emergeney in patients with hepatic cirrhosis undergoing lienectomy. Methods Forty patients with posthepatitic cirrhosis and hypersplenia were randomly divided equally into two groups. In general anesthesia, the analgesic for Group I was remifentanil and for group II was fentanil. Such postoperative parameters as the time of openning eyes by awaking, time for spontaneously breathing, time of extuhation and time of answering question correctly were recorded. Conscious state of patients after extubation instantly, 30 min and 60 min was also observed. Results Times of eyes open by awaking, recovery for spontaneously breathing, extubation and answering question correctly in group I are significantly shorter than that in group II （P〈0.05）. Conclusion Remifentanil is a more ideal analgesic than fentanil in patients with hepatic inadequacy undergoing surgery on aspect of postoperative emergency.

关 键 词：雷米芬太尼 芬太尼 肝硬化 苏醒 

分 类 号：R614[医药卫生—麻醉学]