摘要
目的评估瑞芬太尼复合异丙酚对脊柱结核手术患者麻醉苏醒期的效果。方法选取西宁市第一人民医院2013年1月至2016年6月期间诊治的60例脊柱结核手术患者,按照数表法随机分为瑞芬太尼复合异丙酚组(A组)和七氟烷组(B组)各30例,所有患者均给予咪达唑仑0.05~0.75 mg/kg、瑞芬太尼1μg/kg、异丙酚1.5 mg/kg剂量诱导麻醉,A组静脉持续泵入瑞芬太尼8~12μg·kg-1·h-1,异丙酚4~6 mg·kg-1·h-1维持麻醉,B组采取5%七氟烷持续吸入维持麻醉,观察并比较两组患者围术期心率、平均动脉压(MAP)等指标,以及手术时间、麻醉苏醒情况和术后不良反应发生情况。结果两组患者术前、术毕时、拔管时及拔管后5 min时的心率、MAP比较差异均无统计学意义(P>0.05);A组患者的手术时间、自主呼吸恢复时间和睁眼时间分别为(122.93±7.26)min、(6.95±2.14)min、(9.61±1.26)min,B组分别为(125.37±8.16)min、(7.02±1.89)min、(10.12±1.05)min,两组比较差异均无统计学意义(P>0.5);而拔管时间A组为(15.63±2.74)min,明显短于B组的(17.75±2.83)min,差异具有统计学意义(P<0.05);术后A组患者的呼吸抑制发生率、术后疼痛VAS评分分别为3.33%、(4.72±1.16)分,B组分别为10.00%、(5.27±2.04)分,两组比较差异均无统计学意义(P>0.05);A组患者术后躁动、恶性呕吐发生率分别为10.00%、0,明显低于B组的33.33%、20.00%,差异均具有统计学意义(P<0.05)。结论瑞芬太尼复合异丙酚全静脉麻醉对脊柱结核手术患者麻醉具有血流动力学稳定、苏醒期躁动及恶性呕吐发生率低的特点,适合临床应用。
Objective To assess the efficacy of remifentanil combined with propofol in patients with spinal tuber-culosis during anesthesia awakening period. Methods Sixty patients of spinal tuberculosis who had underwent surgery inXining First People＇s Hospital form Jan. 2013 to Jun. 2016 were chosen. They were randomly divided into group A（remifen-tanil combined with propofol） and group B（sevoflurane）, with 30 cases in each group. The patients were all given midazolam0.05-0.75 mg/kg, remifentanil 1 μg/kg, propofol 1.5 mg/kg for anesthesia induction. Group A was then given remifentanil 8-12 μg·kg-1·h-1 and propofol 4-6 mg·kg-1·h-1 to maintain anesthesia, and group B received 5% sevoflurane for sustained anes-thesia. The changes of perioperative heart rate, mean arterial pressure（MAP）, operation time, anesthesia awakening, postoper-ative adverse reactions were compared between the two groups. Results There differences were not significant between thetwo groups in heart rate, MAP at preoperative baseline, after surgery, at extubation, and 5 minutes after extubation（P〈0.05）.The duration of operation, the recovery time of spontaneous breathing and the time of opening eyes were（122.93±7.26）min,（6.95±2.14） min,（9.61±1.26） min in group A, versus（125.37±8.16） min,（7.02±1.89） min,（10.12±1.05） min in groupB（P〈0.5）. The time of extubation was（15.63±2.74） min in group A, significantly shorter than（17.75±2.83） min of the con-trol group（P〈0.05）. The incidence of postoperative respiratory depression, VAS score of postoperative pain in group A were3.33%,（4.72±1.16）, versus 10.00%,（5.27±2.04） in group B（P〈0.05）. The incidences of restlessness and pernicious vomit-ing in group A were 10.00% and 0, which was significantly lower than 33.33%, 20.00% in group B（P〈0.05）. Conclusion The combined application of remifentanil and propofol for intravenous anesthesia has characteristics of hemodynamic stabil-ity, low incidence of agitation and pernicious vomiting in patients with spinal tuberculosis undergoing surgery, which is suit-able for clinical application.
出处
《海南医学》
CAS
2017年第23期3867-3869,共3页
Hainan Medical Journal
基金
青海省西宁市科技支撑计划项目(编号:162302052)
关键词
瑞芬太尼
异丙酚
脊柱结核
七氟烷
麻醉苏醒期
Remifentanil
Propofol
Spinal tuberculosis
Sevoflurane
Anesthesia awakening period
