摘要
目的:比较瑞芬太尼、芬太尼以及芬太尼联合瑞芬太尼在胃肠道全麻术中的麻醉效果。方法:回顾性分析本院采用瑞芬太尼、芬太尼以及芬太尼联合瑞芬太尼全麻,在胃肠道手术中的应用价值。将ASAⅠ～Ⅱ级腹部胃肠道手术患者90例,随机分为三组:瑞芬太尼组、芬太尼组和联合用药组,每组各30例。芬太尼组采用血浆靶控芬太尼术中镇痛,根据患者术中反应情况决定用药剂量;瑞芬太尼组麻醉方法与芬太尼组相同;复合麻醉组用瑞芬太尼复合芬太尼麻醉。结果:瑞芬太尼组、联合用药组的拔管后即刻、离开监护病房、拔管后1hOAA/S评分明显比芬太尼组高(P<0.05)。联合用药组患者拔管后即刻、离开监护病房时疼痛评分与瑞芬太尼组相比,差异有统计学意义(P<0.05)。瑞芬太尼组苏醒期心率和平均动脉压与其余两组相比,明显增高(P<0.05)。瑞芬太尼组患者苏醒期发生心动过速,均比其余两组增多明显。与芬太尼组相比,瑞芬太尼组和联合用药组拔管时间、术后苏醒时间明显缩短(P<0.05)。联合用药组瑞芬太尼用量与瑞芬太尼组相比,明显减少(P<0.05),联合用药组芬太尼用量与芬太尼组相比,明显减少(P<0.05)。结论:三种麻醉方法均能满足胃肠道手术要求,但是瑞芬太尼和芬太尼联合应用,术中可维持患者血流动力学稳定,术后苏醒时间短,值得临床推广应用。
Objective：To make a comparative study on the feasibility and validity of using remifentanil、fentanyl and remifentanil in general anaesthesia. Methods：Retrospective study using remifentanil,fentanyl and remifentanil fentanyl anesthesia in gastrointestinal surgery value. The ASA Ⅰ-Ⅱ grade abdominal gastrointestinal surgery 90 patients were randomly divided into three groups：the remifentanil group and fentanyl group and combination group,each group was 30 cases. Fentanyl group received fentanyl plasma target-controlled analgesic,according to reactions in patients with intraopera -tive decision dosage; remifentanil group and fentanyl anesthesia group the same; combined with remifentanil anesthesia group fentanyl anesthesia. Results：The remifentanil group,anesthesia combined treatment group immediately after extubation,leaving care unit,after the removal of 1 hour OAA/S score was significantly higher than the fentanyl group （ P〈0.05）. Combined group of patients immediately after extubation,pain scores when leaving care unit with the remifentanil group,significant difference （P〈0.05）. Remifentanil group recovery period heart rate and mean arterial pressure compared with the other two groups,significantly higher （P〈0.05）. Remifentanil group occurred in patients with tachycardia recovery period,significantly more than the other two groups. Compared with fentanyl,remifentanil group and combined anesthesia group,extubation time,postoperative recovery time was significantly shorter （P〈0.05）. Combined anesthesia group,the amount of remifentanil compared with remifentanil,decreased significantly （P〈0.05）,fentanyl combination anesthesia group compared with the fentanyl group decreased significantly （P〈0.05）. Conclusion：Three types of anesthesia can meet the requirements of gastrointestinal surgery,but the combination of remifentanil and fentanyl,intraoperative hemodynamic stability can be maintained in patients,postoperative recovery time is short,worthy of clinical application.
出处
《中国当代医药》
2010年第23期66-68,共3页
China Modern Medicine
关键词
瑞芬太尼
芬太尼
全身麻醉
Remifentanil
Fentanyl
General anesthesia
