文档介绍：瑞芬太尼芬太尼及瑞芬太尼复合全麻的对照研究
作者:周清河肖旺频姚明安尔丹杜炎芳
【摘要】目的对比研究瑞芬太尼、芬太尼复合瑞芬太尼在全麻术中应用的可行性和有效性。方法 ASAⅠ~Ⅱ级腹部胃肠道手术患者60例随机分为三组: F、R组和RF组,每组20例。F组血浆靶控芬太尼术中镇痛,芬太尼血浆靶浓度根据手术刺激调整,手术结束前半小时停止;R组用瑞芬太尼替代芬太尼;RF组瑞芬太尼复合芬太尼,胃肠道吻合操作完成前主要由芬太尼维持镇痛,其后主要由瑞芬太尼维持镇痛。结果 R组诱导时发生呛咳、肌肉强直、心动过缓均比其余两组多。R组苏醒期MAP和HR与其余两组相比明显增高(P<)。苏醒期R组发生躁动、高血压、心动过速均比其余两组增多明显。与F组相比,R和RF组拔管时间、出恢复室时间明显缩短(P<)。RF组瑞芬太尼用量与R组相比明显减少(P<),RF组芬太尼用量与F组相比明显减少(P<)。R、RF组的拔管后即刻、离开PACU、拔管后 1h OAA/S 评分明显比F组高(P<)。RF组患者拔管后即刻、离开PACU时疼痛评分与R组相比,差异显著(P<)。结论三种麻醉方法术中均能提供良好的镇痛,满足手术要求。但瑞芬太尼联合芬太尼既能提供完善的镇痛,维持术中血流动力学平稳,术毕又能苏醒迅速且苏醒质量高。
【关键词】芬太尼瑞芬太尼全身麻醉靶控输注
【Abstract】 Objective To make a parative study on the feasibility and validity of using remifentanil、fentanyl and remifentanil in general anaesthesia. Methods 60 ASA classⅠ~Ⅱpatients undergoing abdomen operations ly divided into three groups: group F、group R and group RF aintained a concentration of fentanyl ulation and stoppet at 30min before the end of surgery. In Group R,fentanyl ifentanil. In Group RF, analgesia aintained ifentanil-fentanyl , analgesia aintained osis and ifentanil afteruscle tore than other tent. MAP and HR in group R anesthesia(P<).The occurrence of fidget、hypertension、tachycardia ore than other t anesthesia(P<).The duration from termination of anesthesia to trachea extubation and the stay in PACU ifentanil used in group RF e point of trac