摘要
目的比较异丙酚复合芬太尼或瑞芬太尼靶控静脉麻醉与传统静脉复合麻醉的效果和区别。方法选择2010年7月～2012年7月84例胆囊切除术的患者,均用咪达唑仑诱导麻醉,维库溴铵维持肌松。选药均为异丙酚复合芬太尼或瑞芬太尼,将患者按自愿选择分为两组,靶控静脉麻醉组42例,传统静脉复合麻醉组42例,靶控静脉麻醉组用计算机操控药物的血浆靶浓度,芬太尼或瑞芬太尼的靶浓度为7.0mg/L,异丙酚的靶浓度为3.0mg/L,意识消失时酌减芬太尼的靶浓度为2.0mg/kg,异丙酚靶浓度保持不变,手术前30min停止芬太尼或瑞芬太尼输入,手术结束时停止异丙酚的输入。传统静脉复合麻醉组手术中维持异丙酚复合芬太尼或瑞芬太尼有效浓度不变。比较两组患者恢复自主呼吸的时间、意识清醒睁眼时间、定向力恢复时间和拔管时间、离开手术恢复室时间和术后患者满意程度和出现不良反应、并发症的比率。结果靶控静脉麻醉组的自主呼吸恢复时间和定向力恢复、睁眼时间,离开手术恢复室时间均比传统静脉复合麻醉组要早,且差异有统计学意义(P<0.05)。患者对麻醉的满意度以及术后出现不良反应的概率两组患者数据差异无统计学意义。结论靶控静脉麻醉方式是更适合的麻醉方式,对术后患者的意识恢复更有利。
Objective To compare the effects and differences between target controlled intravenous anesthesia and traditional intravenous compound anesthesia by taking propofol combined with fentanyl or remifentanil. Methods Eighty-four cases of cholecystectomy patients were chosen from July in 2010 to July in 2012 and they all were anesthetized by midazolam, maintaining muscle relaxed with vecuronium. Selected propofol combined with fentanyl and remifentanil, patients were divided into two groups according to freewill choice, the target controlled intravenous anesthesia group and the traditional intravenous compound anesthesia group, and each group had 42 cases. The target concentration of fentanyl or remifentanil was 7.0 mg/L, the target concentration of propofol was 3.0 mg/L in the target controlled intravenous anesthesia group, and the drug target plasma concentration was controlled by computer. In the condition of unconsciousness, the target concentration of fentany was decreased to 2.0 mg/L, propofol target concentration remained unchanged. Stopped inputting the fentanyl or remifentanil propofol 30 minutes before the operation, and stopped inputting propofol at the end of the operation. Maintained the propofol combined with remifentanil or fentanyl concentration constantly in the operation of the traditional intravenous compound anesthesia group. Compared the two groups of patients with restoration of spontaneous breathing time, conscious goggle time, directional force recovery time and extubation time, recovery room time of leaving the operation, postoperative patients satisfaction degree and the rate of the occurrence of adverse reactions and complications. Results The independent respiratory recovery time and directional force recovery, goggle time, and the recovery room time of leaving the operation in the target controlled intravenous anesthesia group were earlier than those in the traditional intravenous compound anesthesia group, and it had statistical significance （P 0.05）. Patients′ satisfaction on anesthesia, and the probability of postoperative reaction of the two groups showed no significant difference and no statistical significance. Conclusion Target controlled intravenous anesthesia is the more suitable method for anesthesia, and the recovery of consciousness on postoperative patients is more favorable.
出处
《中国当代医药》
2013年第2期87-88,90,共3页
China Modern Medicine
关键词
异丙酚
芬太尼
瑞芬太尼
靶控静脉麻醉
传统静脉复合麻醉
Propofol
Fentanyl
Remifentanil
Targeting controlled intravenous anesthesia
Traditional intravenous compound anesthesia
