小剂量瑞芬太尼静脉输注预防全麻苏醒期烦躁的疗效观察  

Study of small doses of remifentanyl in preventing emergence agitation after general anesthesia

作　　者：张文生[1] 梁爱梅[1] 周立民[1] 李俊[1] 

机构地区：[1]泰山医学院附属医院麻醉科,山东泰安271000

出　　处：《泰山医学院学报》2012年第6期426-427,共2页Journal of Taishan Medical College

摘　　要：目的观察全麻苏醒期输注小剂量瑞芬太尼预防术后苏醒期躁动的效果。方法将120例腹部全麻手术的择期手术患者随机分为A组和B组,每组60例。两组均以咪达唑仑、阿曲库铵、芬太尼、依托咪酯诱导,丙泊酚+瑞芬太尼+硬膜外阻滞维持麻醉,A组缝皮时停止输注丙泊酚和瑞芬太尼,B组缝皮时停止输注丙泊酚,瑞芬太尼输注剂量减为0.05μg/kg/min,拔除气管导管后停用瑞芬太尼。分别纪录两组患者的麻醉时间、自主呼吸恢复时间、睁眼时间、拔管时间、苏醒期患者的躁动情况、拔管前患者的MAP、HR、SpO2。结果两组患者麻醉时间、自主呼吸恢复时间、睁眼时间、拔管时间差异无统计学意义(P>0.05),患者出现苏醒期烦躁的比率B组较A组小(P<0.05),在拔管期间患者血流动力学B组比A组更平稳(P<0.05)。结论全麻苏醒期输注小剂量瑞芬太尼可以使麻醉苏醒更平稳,可有效预防全麻苏醒期烦躁的发生。Objective： To observe the effect of small dose of remifentanil on preventing emergence agitation after general anesthesia.Methods： 120 cases undergoing selective abdominal operation were randomly divided into Group A and Group B（n=60）.Both groups were induced with midazolam,atracurium,fentanyl,etomidate,and were maintained with propofol,remifentanyl.And all cases were combined with epidural anesthesia.At the beginning of suturation,the infusion of both propofol and remifentanyl were stopped in Group A.The infusion of propofol was stopped in Group B,too,but the infusion of remifentanyl was mentained up to extubation just reduced the dosage to 0.05 ug/kg/min.The anesthesia time,the spontaneously breathing recovery time,the time of open eyes,extubation time,emergence agitation,and MAP,HR and SpO2 at the time of extubation were recorded.Results： There was no statistical difference in the anesthesia time,the spontaneously breathing recovery time,the time of open eyes and the extubation time in both the A and B groups（P〉 0.05）.The ratio of emergence agitation was lower in Group B than in Group A（P〈0.05）.The hemodynamics was more stable in Group B than in Group A at the time of extubation（P〈0.05）.Conclusion： Small doses of remifentanil can make more stable hemodynamics during the stage of analepsia.And small doses of remifentanil can effectively prevent the ratio of emergence agitation after general anesthesia.

关 键 词：瑞芬太尼 全身麻醉 苏醒期烦躁 

分 类 号：R614[医药卫生—麻醉学]