瑞芬太尼复合异丙酚在宫颈锥切术中的应用

Application of Total Intravenous Anesthesia with Remifentanyl Combined with Propofol for Cervial Conization

目的:评价瑞芬太尼复合异丙酚应用于宫颈锥切术中的临床效果及安全性。方法:选择行宫颈锥切术患者60例,随机分为瑞芬太尼复合异丙酚组(R组)以及腰硬联合麻醉组(C组)各30例。R组用微量泵输注瑞芬太尼复合异丙酚静脉全麻;C组采用腰硬联合麻醉。使用GESolar8000型监测仪记录术前、手术开始时、手术开始后5min及R组患者术后苏醒时的平均动脉压、心率、脉搏氧饱和度及呼吸频率,监测动脉血二氧化碳分压;记录R组患者呼吸暂停例数。术后24h随访患者对手术的记忆,术后并发症和麻醉满意度。结果:瑞芬太尼复合异丙酚静脉全麻可以满足手术需求,术后并发症少,患者对手术无记忆,满意度高于腰硬联合麻醉。结论:静脉微量泵注瑞芬太尼复合异丙酚麻醉效果确切、安全,可在宫颈锥切术中应用,但需要加强呼吸、循环监护与管理。

Objective： To evaluate the efficacy and safety of total intravenous anesthesia with remifentanyl and propofol in cervial conization. Methods： Sixty patients scheduled for cervial conization were divided randomly into group R and group C. Patients in group R received remifentanyl combined with propofol infusion by micropump, while those in group C received lumbar- epidural synaptic anesthesia. The data of the mean arterial pressure （MAP）,heart rate （HR）, pulse oxygen saturation （SpO2）, respiratory rate （RR） and partial pressure of carbon dioxide in artery（PaCO2） were recorded. The number of apnea were recorded in group R. The memory of operation, complication and proportion of satisfaction were followed up after 24 hrs. Results： Total intravenous infusion of remifentanyl combined with propofol can satisfy the demand of operation, have less complication and more satisfaction than lumbar-epidural synaptic anesthesia. Conclusions： Total intravenous anesthesia with remifentanyl and propofol for cervial conization is safe and reliable. Respiration depression should be monitored instantly and strictly.