瑞芬太尼微量泵输注在眼科局麻手术镇静镇痛中的应用  

Application of micropump infusion of remifentanil in sedation and analgesia technique during ophthalmic surgery under local anesthesia

作　　者：于军[1] 何欣[1] 邵勇平[1] 

机构地区：[1]西安市第四医院麻醉科,西安710004

出　　处：《陕西医学杂志》2011年第2期210-212,共3页Shaanxi Medical Journal

摘　　要：目的:探讨微量泵输注瑞芬太尼用于眼科局麻手术镇静镇痛的有效性和安全性。方法:择期行眼科局麻手术患者80例,ASA I或级,随机均分为观察组和对照组。观察组术中微量泵输注瑞芬太尼0.067μg.kg-1.min-1,对照组不用。分别于静脉给药前、手术开始后15min、30min和手术结束时进行镇静评分和疼痛评分。记录舒芬太尼追加剂量,观察术中不良反应的发生情况。结果:两组患者手术开始后15min、30min、手术结束时镇静评分、疼痛评分显著高于静脉给药前(P<0.05)。观察组患者手术开始后30min、手术结束时镇静评分显著高于对照组(P<0.05)。观察组患者手术结束时疼痛评分显著低于对照组(P<0.05)。观察组患者舒芬太尼追加剂量显著低于对照组(P<0.05)。观察组患者心动过缓的发生率显著高于对照组(P<0.05),躁动呻吟的发生率显著低于对照组(P<0.05)。结论:瑞芬太尼微量泵输注用于眼科局麻手术镇静镇痛安全有效。Objective：To evaluate the efficacy and safety of micropump infusion of remifentanil in sedation and analgesia technique during ophthalmic surgery under local anesthesia.Methods：Eighty ASA Class I or Ⅱ patients undergoing the elective ophthalmic surgery under local anesthesia were randomly divided into two groups with 40 cases each.The patients received micropump infusion of remifentanil 0.067μg·kg^-1·min^-1（group R）or not（group C） respectively.Pain scale and sedation scale were measured at 4 intervals： before administration of anesthesia,15,30min after surgery beginning and the end of surgery.An additional dose of sufentanil and adverse reactions were recorded.Results：15,30min after surgery beginning and the end of surgery,pain scale and sedation scale were significantly higher than that before administration of anesthesia（P0.05）.At 30min after surgery beginning and the end of surgery,sedation scale of group R was significantly higher than that in group C（P0.05）.Compared with patients in group C,group R pain scale of the end of surgery was significantly lower（P0.05）.An additional dose of sufentanil of group R was significantly lower than that in group C（P0.05）.Compared with patients in group C,group R the incidence of bradycardia was significantly higher（P0.05）,and the incidence of restlessness and groan was significantly lower（P0.05）.Conclusion： Micropump infusion of remifentanil is effective and safe for sedation and analgesia during ophthalmic surgery under local anesthesia.

关 键 词：眼外科手术 清醒镇静 镇痛 @瑞芬太尼 

分 类 号：R779.6[医药卫生—眼科]