摘要
目的雷米芬太尼用于颅脑显微手术关颅期对苏醒质量影响。方法 45例颅脑手术患者均分为三组,在关硬脑膜时分别应用雷米芬太尼(R组)、丙泊酚(P组)或异氟醚(I组)处理。三组均在术毕前2min停药,记录围苏醒期循环和Ramsay评分。结果 P、I组关颅期均有明显HR增快和MAP升高(P<0.05);但R组则较平稳。R组在拔管时HR明显慢于P组和I组[(84.7±10.5)次/分vs.(95.1±10.8)次/分和(96.3±10.9)次/分](P<0.05),MAP也明显低于P组和I组[(79.8±4.1)mmHgvs.(109.2±5.2)mmHg和(103.3±5.8)mmHg](P<0.05)。拔管后10min,R组和P组的Ramsay评分显著低于I组。结论在关颅期靶控输注雷米芬太尼或丙泊酚均能早期苏醒拔管,雷米芬太尼更有利于抑制手术刺激和围拔管期的高血压,提高苏醒质量。
Objective To investigate the effects of three anesthetics on early postoperative hypertension,Ramsay scores in patients undergoing craniotomy.Methods Forty-five patients under propofol-fentanyl-isoflurane anesthesia were divided to three groups with 15 cases each.At the beginning of dural closure,the patients were treated with TCI remifentanil （group R）,propofol（group P） or isoflurane inhalation（group I） until skin closure.MAP,HR and Ramsay score were recorded during recovery period.Results MAP and HR were increased in groups of P and I,which were stable in group R.During extubation,HR was lower in group R than that in groups of P and I [（84.7±10.5） vs.（95.1±10.8） and （96.3±10.9） beats/min]（P0.05）,so did MAP [（79.8±4.1） vs.（109.2±5.2） and （103.3±5.8） mm Hg]（P0.05）.Ramsay score at 10 min after extubation was lower in group R than that in groups of P and I.Conclusion TCI remifentanil during dural closure and recovery from general anesthesia is better than propofol or isoflurene for stablizing circulation and improving awakening quality in neurosurgical patients.
出处
《江苏医药》
CAS
CSCD
北大核心
2010年第16期1886-1887,共2页
Jiangsu Medical Journal
