异丙酚和瑞芬太尼靶控静脉麻醉的诱导和术后苏醒过程评价  

Propofol and remifentanil target controlled recovery process evaluation intravenous anesthesia induction and after operation

作　　者：盖赵辉[1] 张云红[1] 佟香芝[1] 刘宏伟[1] 张艳丽[1] 

机构地区：[1]大庆龙南医院麻醉科,黑龙江大庆163000

出　　处：《临床和实验医学杂志》2014年第9期753-756,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的：对瑞芬太尼与异丙酚靶控静脉麻醉的诱导和术后苏醒过程进行评价。方法选取2012年2月至2014年2月收治的美国麻醉师协会（ASA）评级Ⅰ--Ⅱ级择期采取腹腔镜胆囊切除术的60例患者，随机将所有患者分成对照组（n =30）与观察组（n =30）。对照组采取静吸复合麻醉方式，观察组采取瑞芬太尼与异丙酚靶控静脉麻醉方式，对比分析两组患者麻醉诱导、语言评价量表（VRS）评分、警觉-镇静（OAAS）评分、术后离开恢复室时间以及定向能力。结果麻醉诱导观察组患者舒张压（DBP）高于对照组，差异有显著性（ P 〈0.05）；两组在心率（HR）、平均动脉压（MAP）以及收缩压（SBP）方面无明显差异（ P 〈0.05）。观察组患者术中发生 SBP 〈90 mmHg、HR 〈50次/ min、呛咳、肌肉僵硬和插管反应的患者比率均明显低于对照组，差异均有显著性（ P 〈0.05）。观察组 VRS 评分、OAAS 评分方面优于对照组，术后离开恢复室时间与定向能力明显低于对照组，差异均有显著性（ P 〈0.05）。结论对于采取腹腔镜胆囊切除术患者采取瑞芬太尼与异丙酚靶控静脉麻醉方式，临床疗效显著，并且术后患者苏醒较快，具有临床应用价值。Objective To evaluate intravenous anesthesia induction and recovery process of remifentanil and propofol target controlled process. Methods From 2012 February to 2014 February,60 cases of laparoscopic cholecystectomy patients were included into this study. The ASA grade of these patients were I to II patients. All patients were divided into two groups randomly（30）and observation group（30）. The con-trol group adopted intravenous inhalation anesthesia. The observation group took remifentanil fentanyl and propofol target controlled infusion anes-thesia induction. Comparative analysis,VRS score,OAAS score,postoperative recovery room time and leave the directional ability of anesthesia in two patients were recorded. Results The induction of anesthesia group had significant difference in DBP（ P 〈 0. 05）. There was no difference between HR,MAP and SBP（ P 〈 0. 05）. During induction of anesthesia,the indicators of the two groups patients had significant difference（ P〈 0. 05）. In the VRS score and OAAS score,there was significant difference in two groups（ P 〈 0. 05）. The patients in the observation group left the recovery room time and orientation were significantly lower than those of the control group（ P 〈 0. 05）. Conclusion For patients with laparoscopic cholecystectomy by remifentanil and propofol TCI anesthesia,the clinical curative effect is remarkable,and postoperative recovery is rapid. This method has the value of clinical application.

关 键 词：靶控静脉麻醉 瑞芬太尼 异丙酚 术后苏醒 评价 

分 类 号：R614[医药卫生—麻醉学]