瑞芬太尼在经鼻蝶垂体瘤切除术中合适剂量的临床观察  

Clinical Observation on the Appropriate Dosage of Remifentanil in Endonasal Transsphenoidal Resection of Pituitary Adenoma

作　　者：曾春红[1] 刘婷婷[1] 杨懿林[1] 赖庆利[1] 

机构地区：[1]绵阳市中心医院麻醉科,四川绵阳621000

出　　处：《医学综述》2015年第5期917-919,共3页Medical Recapitulate

摘　　要：目的探讨不同剂量瑞芬太尼在经鼻蝶垂体瘤切除术中的临床效果,指导临床使用合适剂量治疗。方法选取绵阳市中心医院2012年6月至2013年6月收治的垂体瘤经鼻蝶切除患者90例作为研究对象,按照随机数字表法分为A组、B组和C组,各30例。所有患者接受相同的麻醉和手术治疗,A、B、C三组患者分别泵入0.0625、0.125、0.25μg/kg瑞芬太尼。记录各组患者的手术时间、麻醉时间和拔管时间,并测定麻醉前(T1)、手术开始时(T2)、蝶窦打开时(T3)、手术结束时(T4)的平均动脉压和心率。结果 3组患者手术时间、麻醉时间及拔管时间比较差异均无统计学意义(P>0.05)。与T1相比,A组T2、T3、T4时的心率明显增快,平均动脉压显著升高(P<0.05),B组和C组患者心率明显减慢,平均动脉压显著降低,差异有统计学意义(P<0.05);C组T2、T3、T4时的心率低于A组,差异有统计学意义(P<0.05)。A组患者追加注射瑞芬太尼的发生率为66.7%,显著高于B组(10.0%),C组患者停止泵入瑞芬太尼的发生率为53.3%,显著高于B组(3.3%),差异有统计学意义(P<0.05)。结论 0.125μg/kg瑞芬太尼是经鼻蝶垂体瘤切除术的合适剂量。Objective To explore the effects of different dosage of remifentanil in the endonasal transs-phenoidal resection of pituitary adenoma,in order to provide guidance for choosing proper dosage in clinical treatment.Methods A total of 90 patients underwent endonasal transsphenoidal resection of pituitary adeno-ma in Mianyang Central Hospital from Jun.2012 to Jun.2013 were selected as the research objects,and divided into group A, B and C according to random number table,with 30 cases in each.All the patients received the same anesthesia and surgery treatment, besides, patients of group A were pumped into 0.0625 μg/kg remifentanil,patients in group B were pumped into 0.125 μg/kg of remifentanil,and patients in group C were pumped into 0.25 μg/kg of remifentanil.The operation time,anesthesia time and extubation time of the three groups was recorder,and the mean arterial pressure and heart rates at the time before anes-thesia（T1）,at the start of surgery（T2）,at the time when sphenoid sinus was opened（T3）, and at the end of surgery（T4） of the three groups were detected.Results There were no statistically significant differences of operation time,anesthesia time and extubation time between either two of the three groups（P〉0.05）.The mean arterial pressure and heart rates of group A at T2,T3,T4 were significantly higher than those at T1（P〈0.05）;the mean arterial pressure and heart rates of group B and group C at T2,T3,T4 were significantly lower than those at T1,the differences were statistically significant（P〈0.05）;and the heart rates of group C were at T2 ,T3 ,T4 were significantly lower than the control group ,the differences were statistically significant （P〈0.05）.Compared with group B,occurrence rate of additional injection of remifentanil in group A was 66.7%,significantly higher than that in group B,while occurrence rate of stopping injection of remifentanil was 53.3%,significantly higher than that in group B,the differences were statistically significant （P 〈0.05）.Conc

关 键 词：鼻蝶 垂体瘤 瑞芬太尼 合适剂量 

分 类 号：R584[医药卫生—内分泌]