异丙酚复合瑞芬太尼靶控麻醉对口腔外科手术患者影响  

Effect of propofol and remifentanil target-controlled anesthesia on patients undergoing oral surgery

作　　者：马彬彬[1] 田文彬[2] MA Binbin;TIAN Wen-bin(Department of Anesthesiology,Fengnan District Hospital,Hebei Tangshan 063300,China;Department of Stomatology,Fengnan District Hospital,Hebei Tangshan 063300,China)

机构地区：[1]唐山市丰南区医院麻醉科,河北唐山063300 [2]唐山市丰南区医院口腔科,河北唐山063300

出　　处：《临床口腔医学杂志》2020年第7期417-420,共4页Journal of Clinical Stomatology

摘　　要：目的:观察异丙酚复合瑞芬太尼靶控静脉输注方式对口腔外科手术患者麻醉期血流动力学、麻醉药用量及麻醉后恢复情况的影响。方法:选取本院72例口腔外科手术患者,以数字表法随机分为2组,每组各36例。对照组靶控静脉输注异丙酚,实验组靶控静脉输注异丙酚复合瑞芬太尼。比较两组麻醉期[麻醉前(T0)、异丙酚或者其复合瑞芬太尼发挥药效时(T1)、局麻时(T2)、手术开始时(T3)、手术中(T4)以及手术结束时(T5)]血流动力学[舒张压(DBP)、收缩压(SBP)、血氧饱和度(SpO2)与心率(HR)]、异丙酚用量、麻醉恢复时间与术后视觉模拟量表(visual analogue scale,VAS)评分、不良反应情况。结果:两组T0、T1、T2、T3、T4、T5 DBP、SBP及HR比较均无明显差异(P>0.05);实验组T1、T2、T3与T5 SpO2 均明显低于对照组(P<0.05),但均基本处于正常范围。实验组异丙酚平均剂量、起效时靶控血浆浓度均明显低于对照组(P<0.05);实验组麻醉恢复时间明显短于对照组(P<0.05)。术后VAS评分明显低于对照组(P<0.05);两组不良反应总发生率比较无显著差异(P>0.05)。结论:口腔外科手术采取异丙酚复合瑞芬太尼靶控静脉输注方式,患者麻醉期血流动力学稳定,可减少异丙酚使用剂量,麻醉后恢复快,获得良好镇痛效果,且安全性高。Objective:The aim is to observe the effect of target-controlled intravenous infusion of propofol combined with remifentanil on hemodynamics,anesthetic dosage and recovery after anesthesia in patients undergoing oral surgery.Methods:Seventy-two patients undergoing oral surgery were enrolled and then randomly divided into two groups by the number table method,36 cases in each group.Patients in the control group were given target-controlled intravenous infusion of propofol,and the experimental group were given target-controlled intravenous infusion of propofol combined with remifentanil.The hemodynamics[diastolic blood pressure(DBP),systolic blood pressure(SBP),blood oxygen saturation(SpO2)and heart rate(HR)]in anesthesia period[before anesthesia(T0),anesthesia onset(T1),local anesthesia(T2),the beginning of surgery(T3),during surgery(T4)and at the end of surgery(T5)],propofol dosage,anesthesia recovery time,postoperative pain visual analogue scale(VAS)scores and adverse reactions were compared between the two groups.Results:There was no significant difference in DBP,SBP or HR between the two groups at each time point(P>0.05).Though SpO2 in the experimental group was significantly lower than that in the control group at T1,T2,T3 and T5(P<0.05),it was in the normal range.The average dosage of propofol and target-controlled plasma concentration at onset in the experimental group were significantly lower than those in the control group(P<0.05).The recovery time of the experimental group was significantly shorter than the control group(P<0.05),and the postoperative VAS score was significantly lower than the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:The application of target-controlled intravenous infusion of propofol combined with remifentanil in oral surgery can help stabilize patients’ hemodynamics during anesthesia and reduce the dosage of propofol.Besides,patients can recover quickly from anesthesia,and the analge

关 键 词：异丙酚 瑞芬太尼 口腔外科手术 血流动力学 恢复 

分 类 号：R782.05[医药卫生—口腔医学]