瑞芬太尼复合丙泊酚麻醉对颅脑手术患者脑氧代谢及血流动力学的影响分析  

Analysis of the Effects of Remifentanil Combined with Propofol Anesthesia on Cerebral Oxygen Metabolism and Hemodynamics in Patients Undergoing Craniocerebral Surgery

作　　者：姚慧欣 吕王成 YAO Huixin;LYU Wangcheng(Department of Anesthesiology,Pizhou Hospital of Traditional Chinese Medicine,Pizhou,Jiangsu Province,221300 China)

机构地区：[1]邳州市中医院麻醉科,江苏邳州221300

出　　处：《系统医学》2023年第14期51-54,共4页Systems Medicine

摘　　要：目的分析瑞芬太尼复合丙泊酚麻醉对颅脑手术患者脑氧代谢及血流动力学的影响。方法选择2021年1月—2022年12月邳州市中医院收治的72例颅脑手术患者为研究对象,以随机数表法分为两组,每组36例。对照组采用芬太尼复合丙泊酚麻醉,观察组采用瑞芬太尼复合丙泊酚麻醉,对比两组血流动力学指标、脑氧代谢、炎症因子水平及麻醉恢复质量。结果观察组麻醉诱导1 min(T2)、气管插管5 min(T3)、气管插管10 min(T4)时刻心率、平均动脉压均较对照组更高,差异有统计学意义(P<0.05)。麻醉诱导前两组脑氧代谢率、颈内静脉血氧含量对比差异无统计学意义(P>0.05);停药5 min时,观察组均高于对照组,差异有统计学意义(P<0.05)。术后,观察组超敏C反应蛋白、白介素-6、肿瘤坏死因子-α水平分别为(21.26±4.25)mg/L、(36.02±7.13)mg/L、(53.91±9.61)µg/L,较对照组的(30.32±5.21)、(58.79±9.57)mg/L、(80.74±9.53)µg/L更低,差异有统计学意义(t=8.085、11.448、11.894,P<0.05)。观察组术后睁眼、睁眼-恢复定向力及拔管时间更短于对照组,差异有统计学意义(P<0.05)。结论予以颅脑手术患者瑞芬太尼复合丙泊酚麻醉效果显著,对患者血流动力学及脑氧代谢影响较小,应激反应轻,麻醉恢复快。Objective To analyze the effects of remifentanil combined with propofol anesthesia on cerebral oxygen metabolism and hemodynamics in patients undergoing craniocerebral surgery.Methods A total of 72 patients with craniocerebral surgery admitted to Pizhou Hospital of Traditional Chinese Medicine from January 2021 to December 2022 were selected as the research objects and divided into two groups by random number table method,with 36 cases in each group.The control group was anesthetized with fentanyl combined with propofol,and the observation group was anesthetized with remifentanil combined with propofol.The hemodynamic indexes,cerebral oxygen metabolism,inflammatory factor levels and quality of anesthesia recovery were compared between the two groups.Results The heart rate and mean arterial pressure at anesthesia induction 1 min(T2),tracheal intubation 5 min(T3),tracheal intubation 10 min(T4)in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in cerebral oxygen metabolism rate and internal jugular vein oxygen content between the two groups before anesthesia induction(P>0.05);at 5 min after drug withdrawal,the observation group was higher than the control group,and the difference was statistically significant(P<0.05).After surgery,the levels of high-sensitivity C-reactive protein,interleukin-6,and tumor necrosis factor-α in the observation group were(21.26±4.25)mg/L,(36.02±7.13)mg/L,and(53.91±9.61)μg/L,was lower than(30.32±5.21)mg/L,(58.79±9.57)mg/L,and(80.74±9.53)μg/L in the control group,and the difference was statistically significa(t=8.085,11.448,11.894,P<0.05).The postoperative eye opening,eye opening-recovery orientation and extubation time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The anesthesia effect of remifentanil combined with propofol is significant in patients undergoing craniocerebral su

关 键 词：颅脑手术 瑞芬太尼 丙泊酚 血流动力学 脑氧代谢 

分 类 号：R713[医药卫生—妇产科学]