异丙酚单用与复合芬太尼在隆鼻术中麻醉效果比较

Comparison between propofol alone and combined with fentanyl in anesthesia for nose augmentation

目的:比较异丙酚单独或复合芬太尼用于无痛隆鼻术中的麻醉效果。方法:就医者40例,随机分配为A组(异丙酚)和B组(异丙酚复合芬太尼),每组各20例。A组静注异丙酚1.5～2mg.kg-1使其入睡后手术开始,术中异丙酚以4～6mg.kg-1.h-1微泵维持。B组先静脉注射芬太尼0.1mg,随后麻醉过程同A组。记录术中体动反应次数、异丙酚用量,记录麻醉前、麻醉后2mi n、5mi n、10mi n、手术结束时的MAP、HR、RR和SPO2,记录麻醉过程中发生的不良反应。结果:B组术中体动反应次数和异丙酚用量都明显少于A组(P<0.01),B组麻醉后2mi n时MAP、HR、RR和SPO2明显下降(P<0.05或P<0.01),但在麻醉后5mi n时都恢复正常。结论:在无痛隆鼻术麻醉中复合芬太尼未明显增加麻醉不良反应,但增强了镇痛效果,能明显减少体动反应,减少异丙酚使用量,降低治疗费用。

Objective To compare the effect of propofol alone with that combined with fentanyl in anesthesia for nose augmentation. Methods 40 patients received nose augmentation were randomized into group A （propofol） and group B （propofol and fentanyl）, each group 20 patients. In group A, propofol 1.5-2mg.kg^-1 was administered i.v. before surgery followed with 4-6mg.kg^-1.h^-1 with microinfusion pump. In group B, fentanyl 0.1 mg i.v. before propofol was used and other procedure was the same as group A. Restless movings, doses of propofol and adverse effects during the procedure were recorded. MAP, HR, RR and SPO2 at preanesthesia, 2min, 5min, 10min and immediately after the surgery were recorded too. Results The restless movings and propofol doses were fewer in group B than in group A （P〈0.05）. MAP, HR, RR and SPO2 significantly decreased at 2 minute in group B （P〈0.05 or P〈0.01）,but resumed to the level of preanesthesia at 5 minute. Conclusion Adverse effects during anesthesia did not significantly increase when propofol combined with fentanyl for nose augmentation. But the efficacy of analgesia was enhanced, thus restless movings, propofol doses and expense of treatment decreased.