芬太尼和瑞芬太尼用于全身麻醉的比较

Comparison of remifentanil and fentanyl in general anesthesia

目的:对比芬太尼和不同浓度的瑞芬太尼应用于全身麻醉的不同。方法:60例行乳腺癌根治术或甲状腺大部切除的病人随机分为3组。常规麻醉诱导,麻醉维持每分钟A组瑞芬太尼0.1μg/kg,B组瑞芬太尼0.3μg/kg,C组芬太尼0.0 3μg/kg,持续静脉输注并吸入异氟醚和O2∶N2O(2∶1)。结果:B组气管插管、切皮、麻醉维持时浅麻醉发生率明显低于A,C组(P<0.01),A,B组术后睁眼和拔管时间明显少于C组(P<0.01)。A,B组术后需要镇痛的人数明显多于C组(P<0.01)。结论:高剂量瑞芬太尼在全身麻醉术中维持血液动力学稳定方面明显优于低剂量瑞芬太尼和芬太尼。

Objective： To compare the efficacy and safety of remifentanil and fentanyl of different doses. Methods： Sixty patients undergoing radical mastectomy or thyroidectomy were randomly divided into 3 groups ： group A, group B, and group C. Anesthesia was induced routinely, and it was maintained by continuous intravenous infusion of remifentanil of 0. 1 μg/（ kg·min） （group A）, remifentanil of 0. 3 μg （kg· min） （group B）, and fentanil of 0. 03 μg/（ kg· min） （group C） and by inhalation of isoilurane and nitrolls oxide in oxygen （2：1 ）. Results： The number of patients exhibiting light anesthesia responses in group B during intnhation and the maintenance of anesthesia was significantly less than that in group A and C （ P 〈 0. 01 ）. The time to opening eyes on command and the time for extubation after surgery in group A and C was siguificantly less than than in group B （ P 〈 0. 01 ）. More patients in group A and B required sedatives for postoperative pain relief than those in group C （ P 〈 0. 01 ）. Conclusions： I-ligh-dese remifentanil can offer superior intraoporative hemodynamic stability compared with low-dese remifentanil and low-dose fentanyl.