舒芬太尼结合异丙酚全凭静脉麻醉对开颅脑肿瘤切除患者苏醒期的影响  

Effect of total intravenous anesthesia with sufentanil + propofol on the awakening period of patients undergoing craniotomy for brain tumor resection

作　　者：姚博炜 王钱荣[1] 穆婧 YAO Bowei;WANG Qianrong;MU Jing(Department of Anesthesiology,Huzhou Central Hospital,Zhejiang,Huzhou 313000,China)

机构地区：[1]浙江省湖州市中心医院麻醉科,浙江湖州313000

出　　处：《中国现代医生》2022年第10期143-146,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2020KY306)。

摘　　要：目的 探讨舒芬太尼结合异丙酚全凭静脉麻醉对开颅脑肿瘤切除患者苏醒期的影响效果。方法 选取2016年6月~2020年6月浙江省湖州市中心医院行开颅脑肿瘤切除的152例患者作为研究对象,按随机数字法将患者分为对照组、研究组。对照组应用瑞芬太尼联合七氟醚麻醉,研究组应用瑞芬太尼维持+舒芬太尼间断静推联合异丙酚麻醉。结果 与对照组比较,研究组T_(1)、T_(2)、T_(3)、T_(4)、T_(5)HR、MAP水平优(P<0.05);研究组呼吸功能恢复时间(7.4±2.3)min、苏醒时间(3.2±0.4)h、吞咽反射时间(9.4±2.1)min、拔管时间(12.3±4.0)min短于对照组呼吸功能恢复时间(15.1±4.2)min、苏醒时间(5.1±1.5)h、吞咽反射时间(16.1±4.9)min、拔管时间(19.4±6.4)min(P均<0.05);研究组发生不良反应的比重(7.8%)低于对照组发生不良反应的比重(38.1%)(P<0.05)。结论 对开颅脑肿瘤切除患者应用舒芬太尼结合异丙酚全凭静脉麻醉,具有显著的麻醉效果,可有效维持血液动力学指标平稳,缩短呼吸功能恢复时间、吞咽反射时间、拔管时间,加快苏醒时间,并有效降低患者在苏醒期发生不良反应的现象,安全性高,有利于改善预后,值得推广。Objective To investigate the effect of total intravenous anesthesia with sufentanil + propofol on the awakening period of patients undergoing craniotomy for brain tumor resection. Methods 152 patients who came to our hospital for craniotomy for brain tumor resection from June 2016 to June 2020 were selected as study subjects, and they were grouped into the control group and the study group according to the random number method. The control group was anesthetized with remifentanil + sevoflurane, while the study group was maintained with remifentanil + intravenously injected with sufentanil in an intermittent manner + anesthetized with propofol. Results The levels of heart rate(HR)and mean arterial pressure(MAP) in the study group were superior to those in the control group at T_(1),T_(2),T_(3),T_(4),and T_(5)(P<0.05). The recovery time of respiratory function, awakening time, swallowing reflex time, and extubation time in the study group(7.4±2.3) min,(3.2±0.4) h,(9.4±2.1) min, and(12.3±4.0) min, respectively) were shorter than those in the control group [(15.1±4.2) min,(5.1±1.5) h,(16.1±4.9) min, and(19.4±6.4) min, respectively](P<0.05). The proportion of adverse reactions in the study group was 7.8%, which was lower than 38.1% in the control group(P<0.05). Conclusion The total intravenous anesthesia with sufentanil + propofol is of greatly significant anesthetic effect in patients undergoing craniotomy for brain tumor resection. It can effectively maintain the stable hemodynamic index, shorten the recovery time of respiratory function, swallowing reflex time and extubation time, accelerate the awakening time, and effectively reduce the occurrence of adverse reactions in patients during the awakening period. In addition, it is conducive to improving the prognosis with high safety, and is worthy of promotion.

关 键 词：舒芬太尼 异丙酚 全凭静脉麻醉 开颅脑肿瘤切除 苏醒期 

分 类 号：R451[医药卫生—治疗学]