瑞芬太尼复合芬太尼在神经外科手术中的应用被引量：1

Rachel fentanyl composite fentanyl nerve surgery in the application

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摘要目的：对比研究瑞芬太尼复合芬太尼与单纯瑞芬太尼或芬太尼在神经外科手术中的应用效果。方法：择期全麻下神经外科手术患者60例，随机分为三组：瑞芬太尼复合芬太尼组（R—F组，n=20）、芬太尼组（F组，n=20）和瑞芬太尼组（R组，n=20）。记录三组患者全麻诱导、维持及苏醒期砰均动脉压（MAP）、心率（HR）；停药至拔除气管导管时间；病人术后1h内的疼痛程度评分（VRS）及意识状态评分（OAA／S）。结果；R、R-F组在气管插管时MAP和HR无明显变化（P〉0．05），而F组在插管时则出现了轻度的血压增高、心率增快（P〈0．05）；F、R—F组在拔除气管导管时MAP和HR无明显变化（P〉0．05），而R组在拔管时则出现了血压增高、心率轻度增快（P〈0．05）。F组比R、R—F两组术后停药至拔除气管导管时间长（P〈0．05），而R、R—F两组的差异无统计学意史（P〉0．05）。R组术后1h内VRS评分明显高于R—F、F组（P〈0．05）。F组术后1h内OAAS评分低于R、RF组（P〈0．05）。结论：与单纯使用瑞芬太尼或芬太尼相比较，瑞芬太尼复合芬太尼可使麻醉更加平稳，苏醒更快更好，术后疼痛发生较少、较轻。 objective comparative study of red fentanyl composite fentanyl and ChanChunRui fentanyl or fentanyl nerve surgery in the application effect. Under the general method of neural electie colorectal surgery patients 60 cases were randomly divided into three groups： Rachel fentanyl composite fentanyl group （R - group F, n = 20） and fentanyl group （n=group F, 20） and fentanyl group （R = 20）, n. Three groups of patients, maintain and general revive period mean arterial pressure （MAP）, heart rate （HR）, Stop drug to pulling the endotracheal tube time, Postoperative pain in patients with lh score （VRS） among and consciousness score （OAA/S）. Results R and R -- group F in tracheal intubation MAP and HR when no obvious changes （P 〉 0.05）, and group F on intubation was slightly when the heartbeat, increased blood pressure increasing fast （P〈0. 05）. F, R -- in group F pulling the endotracheal tube MAP and HR when no obvious changes （P〉 0.05）, and R group was extubated when blood pressure and heart rate increased slightly faster （P 〈 0.05）. Group F R and R -- more than two group F pulling withdrawal to long endotracheal tube （P 〈 0.05）, and R and R -- F two group of difference was statistically significant （P 〉 0.05）. R group was obviously higher than VRS scores within the lh group F R -- F, （P〈0.05）. In group F score below OAAS postoperative 1h R, RF group （P 〈 0.05）. Conclusion with the simple use red fentanyl or fentanyl compared, and fentanyl composite fentanyl can make more smooth, revive anesthesia is better, faster postoperative pain occurs less and less.

作者刘凤梅魏桂良张忠

机构地区湖南省岳阳市一人民医院麻醉科

出处《医学信息（下旬刊）》 2010年第7期65-65,67,共2页 Medical information

关键词瑞芬太尼芬太尼神经外科手术 rui fentanyl Fentanyl Nerve surgery

分类号 R614 [医药卫生—麻醉学]

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参考文献10

1余淑珍,刘保江.瑞芬太尼的药理学、临床研究和应用进展[J].国外医学（麻醉学与复苏分册）,2004,25(6):356-358. 被引量：121
2Buniatian AA,Mizikov VM,Lovtsevich NV.Esterase metabolized remifentanilhydrochloride opioid (Ultiva2TM),a new step towards the solution of the problem of regulation of analgetic components of general anesthesia.Anesteziol Reanimatol,2001,(2):4-7.
3Scott LJ,Perry CM.Remifentanil:are view of its use during the induction and maintenance of general Anaesthesia[J].Drugs,2005,65:1793-1823.
4Wilhelm W,Schlaich N,Harrer J,etal.Recovery and neurological examination after remifentanil-desflurane or fentany-desflurane anaesthesia for carotid artery surgery[J].Br J Anaesth,2001,86(1):44 -49.
5Djian MC,Blanchet B,Pesce F,etal.Comparison of the time to extubation after use of remifentanil or sufentanil in combination withp ropofol as anesthesia in adults undergoing nonemergency intracranial surgery:aprospective,randomized,double blindtrial[J].Clin Ther,2006,28:560-568.
6Jellish WS,Sheikh T,Baker WH,et al.Hetmdynamic stability,myocardial ischemia,and perioperative outcome after carotid surgerywith remifenfentanil -propofol or influrane -fentanyl anesthesia.J Neurosurg Anesthesiology,2003,15 (3):176-184.
7Wong AYC,O'Regan AM,Irwin MG.Total intravenous anaesthesia with propofol and remifentanil for elective neurosurgical procedures:an audito fearly postoperative complications[J].Euro J Anaesth,2006,23:568-590.
8LI Henglin,WANG Dazhu.Neurosurgical Anesthesia Practice[M].Beijing:People's Medical Publishing House,2004:253-265.
9Bai N,Guo Q,Cheng Z,Wang Y,Yang S.Remifentanil and fentany combined with propofol administered by target controlled infusion in neurosurgery.Zhong Nan Da Xue Xue Bao Yi Xue Ban.2009 Jan;34(1):59-62.
10胡云,全守波,刘菊英,秦成名.瑞芬太尼复合芬太尼全凭静脉麻醉用于腹腔镜胆囊切除术的临床研究[J].中国微创外科杂志,2007,7(9):886-889. 被引量：6

二级参考文献29

1David S. Hemodynamics and emergence profie of remmifentanil versus fentanyl prospectively compared in a large population of surgical patients. Survey of Anesthesiology,2002,46(4): 207-208.
2Enrique C, Antonio P, Pedro A, et al. A comparison of two constant-dose continuous infusion of remifentanil for severe postoperative pain. Anesthesia & Analgesia, 2001,92(3) :715-719.
3Stefan S, Matthew C, Gavin K. Lack of rapid development of opioid tolerance during alfentanil and remifentanil infusion for postoperative pain. Anesthesia & Analgesia, 1999,89(3): 753.
4Penny KJ, Randall S, James S. The use of remifentanil infusion to allow intraoperative awakening for intentional fracturing of the anterior cervical spine. Anesthesia & Analgesia, 1999,89(4): 1059-1062.
5Danelli G,Berti M, Casati A, et al. Spinal block or total intravenous anaesthesia with propfol and remifentanil for synaecological outpatient procedures. European Journal of Anaesthesiology,2002, 19(8) :594-599.
6Jones R, Pegrum A, Stacey RG. Patient-controlled analgesia using remifentanil in the parturient with thrombocytopaenia. Anaesthesia, 1999,54(5):461-465.
7Victor C, Gilles G, Gilles G, et al. Target-Controlled Infusion for Remifentanil in Vascular Patients Improves Hemodynamics and Decreases Remifentanil Requirement. Anesthesia & Analgesia, 2003,96( 1 ): 33-38.
8Servin F, Desmonts JM, Watkins WD. Remifentanil as an analgesic adjunct in local/regional anesthesia and in monitored anesthesia care. Anesth Analy, 1999,89(4) :28-32.
9Myre K, Raeder J, Rostrup M, et al. Catecholamine release during laparoscopic fundoplication with high and doses of remifentanil. Acta Anaestheiol Scand,2003,47(3): 267-273.
10Barvais L, Engelman E, Eba JM, et al. Effect site concentration of remifentanil and pupofol to noxious stimulation. British Journal of Anaesthesia,2003,91 (3) :347-352.