瑞芬太尼复合丙泊酚麻醉在经眶上锁孔入路切除鞍区巨大肿瘤中的应用  

Applications of Remifentanil and Propofol-inducing Anesthesia in Transsupraorbital Keyhole Approach for the Resection of Giant Pituitary Adenomas

作　　者：远征[1,2] 朱坚忠[1,2] 黄文思[1,2] 

机构地区：[1]海口市人民医院,海口市570208 [2]中南大学湘雅医学院附属海口医院麻醉科,海口市570208

出　　处：《中国药房》2010年第20期1856-1857,共2页China Pharmacy

摘　　要：目的:探讨瑞芬太尼复合丙泊酚静脉麻醉在经眶上锁孔入路切除鞍区巨大肿瘤中的应用。方法:42例鞍区巨大肿瘤均行经眶上锁孔入路切除手术,随机分为2组,A组行瑞芬太尼复合丙泊酚持续泵注维持麻醉;B组行芬太尼复合丙泊酚持续泵注维持麻醉。分别记录2组平均动脉压、心率、呼气末二氧化碳分压、苏醒参数(睁眼时间、自主呼吸恢复时间、拔管时间)及术后并发症情况。结果:2组患者的麻醉过程平稳,均能顺利完成手术,麻醉效果满意。无1例术后出现麻醉相关并发症。但A组在插管后和拔管后血压、心率的变化小于B组(P<0.05);各项苏醒参数也优于B组(P<0.05)。结论:与芬太尼比较,瑞芬太尼复合丙泊酚静脉麻醉,诱导时间更短,麻醉维持期血流动力学更稳定,清醒快而完全,更适于经眶上锁孔入路鞍区巨大肿瘤切除手术。OBJECTIVE：To study the application of remifentanil and propofol-inducing intravenous anesthesia in transsupraorbital keyhole approach for the resection of giant pituitary adenomas. METHODS：42 patients with giant tumors in sellar region were randomized into 2 groups. Patients of 2 groups were intubated in respiration tract after intravenous anesthesia. Anesthesia was maintained with either remifentanil combined with propofol （group A） or fentanyl combined with propofol （group B） with continuous infusion. Mean arterial blood pressure, heart rate, end-tidal carbon dioxide partial pressure situation, wake parameters （eyes open time, self-breathing recovery time, extubation time） and postoperative complications were recorded. RESULTS：The symptoms of patients during anesthesia kept steady. Operation and anesthetic effect were completed. There were no relevant complication after operation. The change of blood pressure and heart rate in group A after intubation and extubation were all less than in group B （P0.05）. The wake parameters in group A were also better than in group B （P0.05）. CONCLUSION： Intravenous anesthesia induced by remifentanil combined with propofol is better than fentanyl for shortening induction time, stabilizing hemodynamics, increasing waking speed for transsupraorbital keyhole approach for the resection of giant pituitary adenomas.

关 键 词：瑞芬太尼 丙泊酚 鞍区巨大肿瘤 麻醉 

分 类 号：R971.2[医药卫生—药品] R969.4[医药卫生—药学]