瑞芬太尼与芬太尼全凭静脉麻醉在腰椎手术中的效果比较  

Comparison of the efficacy of remifentanil and fentanyl in total intravenous anesthesia for lumbar spine surgery

作　　者：苏鸿莉[1] 晋雅凌 李玲霞[1] 高慧[1] 路喻清[1] 

机构地区：[1]延安大学附属医院麻醉科,陕西延安716000 [2]陕西省第四人民医院产科,西安710000

出　　处：《实用药物与临床》2016年第11期1376-1378,共3页Practical Pharmacy and Clinical Remedies

基　　金：陕西省卫生科研项目(2014-D27)

摘　　要：目的比较腰椎手术患者应用瑞芬太尼-丙泊酚与芬太尼-丙泊酚全凭静脉麻醉后的麻醉恢复速度及围手术期的镇痛药需求。方法选取2015年2月至2016年1月于我院择期行腰椎间盘手术患者（ASAⅠ~Ⅲ级）80例,随机分为2组,每组40例。瑞芬太尼组患者接受瑞芬太尼-丙泊酚全凭静脉麻醉,芬太尼组患者接受芬太尼-丙泊酚全凭静脉麻醉。监测两组患者的麻醉时间、术后苏醒时间、麻醉恢复室停留时间、围手术期阿片类镇痛药及止吐药的需求情况等。结果两组患者所用的麻醉时间、苏醒时间和麻醉恢复室停留时间比较差异无统计学意义,但瑞芬太尼组患者术后阿片类和非阿片类镇痛药的用药量多于芬太尼组。结论腰椎间盘手术患者应用瑞芬太尼或芬太尼全凭静脉麻醉后,麻醉恢复速度相同,但前者对镇痛药的需求更大。Objective To compare the recovery rate and the perioperative analgesic requirements in patients who received total intravenous anesthesia（TIVA） with remifentanil-propofol or fentanyl-propofol for lumbar spine surgery.Methods Eighty patients with ASA Ⅰ~Ⅲ undergoing elective lumbar vertebral disc surgery in our hospital from February 2015 to January 2016 were randomly divided into two groups.Patients in remifentanil group（n =40） received remifentanil-propofol TIVA,and patients in fentanyl group（n = 40） received fentanyl-propofol TIVA.The anesthesia time,postoperative recovery time,stay length in post anesthesia care unit（PACU） and perioperative opioid analgesic and antiemetic use were monitored and recorded.Results No obvious difference in anesthesia time,recovery time,or the stay length in PACU was found between the two groups,but postoperative opioid and nonopioid analgesic use was significantly higher in remifentanil-propofol group.Conclusion Remifentanil and fentanyl are equally efficient with regard to the anesthetic recovery rate when used as part of TIVA for lumbar disc surgery,but remifentanil group requires more analgesics.

关 键 词：瑞芬太尼 芬太尼 全凭静脉麻醉 腰椎手术 

分 类 号：R614.2[医药卫生—麻醉学]