七氟醚复合雷米芬太尼快通道麻醉在鼻内窥镜手术中的应用  

Application of sevoflurane combined remifentanil fast-track anesthesia in nasal endoscopic surgery

作　　者：陈惠荣[1] 胡晓云[2] 赵海涛[1] 吕浩[1] 刘永勤[1] 

机构地区：[1]海军总医院麻醉科,北京市100037 [2]北京世纪坛医院麻醉科

出　　处：《临床麻醉学杂志》2010年第4期289-291,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察七氟醚复合雷米芬太尼快通道麻醉在鼻内窥镜手术中的应用效果。方法 60例择期行鼻内窥镜手术患者,年龄21～55岁,随机分为三组,每组20例。Ⅰ组全凭吸入七氟醚麻醉,Ⅱ组丙泊酚复合雷米芬太尼,Ⅲ组七氟醚复合雷米芬太尼。观察三组患者术中、术后血流动力学变化,记录术后拔管时间、清醒时间、术后躁动评分(RS)、意识状态评分(OAA/S)等。结果三组术中血压控制均较满意。术后Ⅱ、Ⅲ组拔管时间及清醒时间较Ⅰ组短,躁动发生率稍低(P<0.05)。结论七氟醚复合雷米芬太尼静吸复合麻醉与丙泊酚复合雷米芬太尼全凭静脉麻醉均为鼻内窥镜手术提供安全、快捷、苏醒彻底的快通道麻醉方法。Objective To evaluate the outcomes of fast track anesthesia with sevoflurane combined with remifentanil in nasal endoscopic surgery. Methods Sixty patients undergoing selective nasal endoscopic surgery were randomly assigned into three groups with 20 cases each. General anesthesia of group I was maintained with sevoflurane inhalation only.that of group II with propofol and rernifentanil infusion.and those of group III with sevoflurane combined with remifentanil infusion. Extuhation time, awake time. restlessness score （RS）, visual analogue scales （VAS）, observer＇s assessment of alertness sedation score （OAA S）. and BP, HR, SpO2 were recorded during and after operation. Results BP was kept stable during operation in all three groups. Compared to group I , extubation time. awake time were shorter and RS lower in groups of II and III （P〈0.05）. Conclusion General anesthesia maintained with sevoflurane combined with remifentanil or with propofolremifentanil infusion can offer saticfactory fast track anesthesia with safe and rapid recoverv for nasal endoscopic surgery.

关 键 词：七氟醚 雷米芬太尼 快通道麻醉 

分 类 号：R614[医药卫生—麻醉学]