亚睡眠剂量丙泊酚对瑞芬太尼术后躁动的抑制作用  

Modulation of remifentanil-induced postoperative agitation by subhypnotic doses of propofol

作　　者：李东华[1,2] 陈艳平[1] 曹德权[1] 

机构地区：[1]中南大学湘雅二医院麻醉科,长沙市410011 [2]滨州医学院附属医院麻醉科

出　　处：《临床麻醉学杂志》2011年第4期362-363,共2页Journal of Clinical Anesthesiology

摘　　要：目的探讨亚睡眠剂量丙泊酚对瑞芬太尼术后躁动的抑制作用。方法择期下腹部手术患者40例，ASAⅠ～Ⅲ级，随机均分为两组，均在手术结束前15min停异氟醚和瑞芬太尼，P组持续输注丙泊酚1．0μg·kg^-1·min，C组不用，两组根据行为疼痛评分追加芬太尼，拔管后15min应用PCA镇痛，记录术后24h应用芬太尼总量。结果C组第一次应用芬太尼的时间明显短于P组（P〈0.05），至拔管后15min追加芬太尼的次数明显多于P组（P〈0．05），术后24h应用芬太尼总量明显多于P组（P〈0．05），拔管后5、10、15min的行为疼痛评分明显高于P组，镇静评分低于P组（P〈0．05）。结论、亚睡眠剂量丙泊酚可以缓解瑞芬太尼引起的术后躁动。Objective To investigate the postoperative analgesic effect of subhypnotic doses of propofol used on remifentanil-induced agitation. Methods A total number of forty ASA Ⅰ -Ⅲ adult patients undergoing major abdominal surgery were randomly assigned to two anesthetic regimens. Isoflurane and remifemanil were discontinued 15 minutes before the end of operation in each group, group P was given a bolus of 1.0 μg·kg^-1·min propofol, and fentanyl was injected intravenously according to MAP, SBP, HR and Pain scores in each group from the moment that remifentanil was discontinued. Pain scores and fentanyl consumption were recorded for 24 postoperative hours. Results Patients in group C required fentanyl significantly earlier than those in group P after remifentanil was discontinued （P〈0.05）,and the times of additional fentanyl required were also much more than patients in group P from the time remifentanil discontinued to 15 minutes after tracheal extubation. The fentanyl consumption in group C was much larger than that in group P in the first 24 postoperative bours（P〈0. 05）. Pain score and ramsay scale of group C were higher at 5,10, 15 rains than that of group P after tracheal extubation （P〈0.05）. Conclusion Subhypnotic doses of propofol have significant suppressive effect on patients with postoperative agitation induced by remifentanyl.

关 键 词：瑞芬太尼 丙泊酚 芬太尼 术后躁动 

分 类 号：R614[医药卫生—麻醉学]