瑞芬太尼与芬太尼在泌尿外科腔镜手术麻醉中的应用效果比较  

Comparison of the effects of remifentanil and fentanyl in the urology endoscopic anesthesia

作　　者：王茂林[1] 武霄[1] 郭金丽[1] 杨兆江 王尚明 Wang Maolin;Wu Xiao;Guo Jinli;Yang Zhaojiang;Wang Shangming(Department of Anesthesiology,the Second People＇s Hospital of Jinzhong,Jinzhong,Shanxi 030800,China)

机构地区：[1]晋中市第二人民医院麻醉科,山西省晋中030800

出　　处：《中国基层医药》2018年第15期1990-1993,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 比较瑞芬太尼与芬太尼在泌尿外科腔镜手术麻醉中的应用效果及不良反应的发生情况.方法 选取晋中市第二人民医院2015年2月至2016年4月需接受泌尿外科手术的患者170例,采用随机数字表法分为研究组和对照组,分别使用瑞芬太尼和芬太尼进行术前麻醉,对比两组患者的麻醉诱导时间、手术时间以及术后清醒时间,详细记录并比较接受两组患者接受麻醉给药前后、气管插管前后以及拔除气管导管前后的平均动脉压以及心率的变化情况,记录对比两组患者不良反应的发生情况,对比两组患者的麻醉用量、麻醉手术费用以及手术过程中患者的出血量.结果 研究组患者的麻醉诱导时间等明显短于对照组（9.8 min比6.9 min）（t＝12.029,P＜0.05）,研究组患者的平均动脉压以及心率变化幅度大于对照组（P＜0.05）,研究组患者的不良反应发生率明显低于对照组（5.9%比12.9%）（χ2＝7.935,P＜0.05）;研究组患者的费用以及出血量明显小于对照组（2 871.4元比3 014.9元;23.4 mL比32.7 mL）（ t＝20.391、17.907,P＜0.05）.结论 瑞芬太尼应用在泌尿外科腔镜手术的术前麻醉过程中能够节约时间,减轻患者家庭的经济负担以及患者的不良反应发生程度,值得临床上广泛推荐使用.Objective To compare the effects of remifentanil and fentanyl in urologic surgery under endoscopic anesthesia and the incidence of adverse reactions in patients.Methods A total of 170 patients undergoing urological surgery admitted to the Second People ＇s Hospital of Jinzhong from February 2015 to April 2016 were randomly divided into the study group and control group according to the digital table ,with 85cases in each group. Remifentanil and fentanyl was used in the study group and control group respectively .The preoperative anesthesia was performed in the patients who received anesthesia before and after tracheal intubation and before and after tracheal intubation,and the time of induction of anesthesia ,the operation time and the time of postoperative wakefulness were compared between the two groups.Pressure and heart rate changes ,the incidence of adverse reactions were recorded and compared between the two groups.The amount of anesthesia ,anesthesia surgery costs and the amount of bleeding during surgery were compared.Results The induction time of anesthesia in the study group was significantly shorter than that in the control group （9.8min vs.6.9min,t＝12.029,P＜0.05）.The mean arterial pressure and heart rate in the study group were significantly larger than those in the control group （ all P＜0.05）.The incidence rate of adverse reactions in the study group was significantly lower than that in the control group （5.9% vs.12.9%,χ2＝7.935,P＜0.05）.The cost and blood loss of the study group were significantly lower than those of the control group （2 871.4 CNY vs.3 014.9 CNY;23.4mL vs.32.7mL,t＝20.391,17.907,all P＜0.05）.Conclusion The application of remifentanil in preoperative anesthesia of urologic surgery can save time ,reduce the economic burden of patients and the incidence of adverse reactions in patients.It is worthy of widely recommended in clinic.

关 键 词：瑞芬太尼 芬太尼 泌尿外科手术 腹腔镜检查 麻醉 

分 类 号：R614[医药卫生—麻醉学]