瑞芬太尼复合七氟烷或异氟烷用于脊柱侧弯矫形术中控制性降压及苏醒质量的比较  

The remifentanil composite sevoflurane or isoflurane for scoliosis induced hypotension during recovery and quality was compared

作　　者：钟惠 范晓华[2] 周斌[3] 杜健儿[2] 

机构地区：[1]攀钢总医院麻醉科,四川攀枝花617023 [2]第二军医大学附属长海医院麻醉科,上海200433 [3]解放军第532医院麻醉科,安徽黄山245041

出　　处：《四川医学》2009年第6期851-853,共3页Sichuan Medical Journal

摘　　要：目的探讨瑞芬太尼复合七氟烷或异氟烷用于脊柱侧弯矫形术中控制性降压及苏醒质量的比较。方法ASAⅠ-Ⅱ级择期行脊柱侧弯矫形术患者30例，随机分为瑞芬太尼＋七氟烷组（S组）和瑞芬太尼＋异氟烷组（D组）。每组15例。两组麻醉诱导相同，麻醉维持分别采用瑞芬太尼＋七氟烷或并氟烷，术中监测吸／呼浓度，使呼气末麻醉药浓度均达到1.3MAC，目标MAP控制在60-65mmHg并维持至术毕，如果超过目标血压，加用丙泊酚。比较两组各时点血流动力学指标、乳酸（Lac）浓度、术毕麻醉恢复情况及复合使用丙泊酚降压例数，评估术后患者苏醒质量。结果两组在控制性降压期间血流动力学指标、Lac浓度差异无统计学意义。术毕呼吸恢复、睁眼、拔管时间S组明显短于D组（P〈0.05）。在拔管即刻s组OAAS评分均高于D组，拔管后30min两组患者差异无统计学意义（P〉0.05），复合使用丙泊酚例数S组少于D组。结论瑞芬太尼复合七氟烷，麻醉可控性好，降压及恢复平稳，苏醒快质量优，适用于脊柱侧弯矫形术。Objective The quality comparison of the remifentanil composite sevoflurane or isoflurane for regained consciousness and induced hypotension in scoliosis surgery was investigated. Methods ASA I and Ⅱ scheduled for seoliosis surgery patients 30 cases were randomly divided into remifentanil composite sevoflurane group （S）and remifentanil composite isoflurane group（D） ,each was 15 cases. Induction of anesthesia was the same as used to maintain anesthesia remifentanil composite sevoflurane or isoflurane, the monitoring of the absorption/respiratory concentration were used, so that end-expiratory anesthetic concentration reached 1.3MAC,MAP was controlled to target 60-65 mmHg and maintain to the end of operation,if the target blood pressure was higher, the propofol was plused. The two groups of de facto hemodynamie parameters,lactate concentration,and recovery after anesthesia propofol antihypertensive compound of a few were compared. Comparison of the average amount of propofol were used in postoperative assessment of the quality of patients regained consciousness. Results The two groups were no significant difference in the induced hypotension during hemodynamie parameters and the concentration of Lae. Complete restoration of breath,eyes open, S extubation time was significantly shorter than that in group D （P〈0.05）. Immediate extubation in group S OAAS score were higher than those in group D,30 minutes after extubation in patients with no significant difference between the two groups （P〈0.05）. Compound with the use of propofol was a few less in group S than Group D. Conclusion Remifentanil composite sevoflurane were controllability,and hypotension and restore smooth,fast recovery superior quality, it was applicable to the scoliosis surgery.

关 键 词：瑞芬太尼 七氟烷 异氟烷 苏醒质量 脊柱侧弯 

分 类 号：R614[医药卫生—麻醉学]