瑞芬太尼复合丙泊酚或地氟烷麻醉用于电视胸腔镜手术患者的临床观察

The anesthesia efficacy of remifentanil-propofol or remifentanil --desflurance in patients undergoing video-assisted thoracoscopic surgery

目的 评价瑞芬太尼复合丙泊酚或地氟烷麻醉在电视胸腔镜手术中的临床效果。方法 将40例经电视胸腔镜治疗自发性气胸的患者，随机分为瑞芬太尼复合丙泊酚静脉麻醉组（P组）和瑞芬太尼复合地氟烷静吸复合麻醉组（D组），每组各20例。对比观察两种麻醉方法术中平均动脉压（MAP）和HR的变化以及术毕停药后呼之睁眼时间、自主呼吸恢复时间、拔管时间及清醒程度（采用拔管后5min镇静评分判断）。结果 D组术中MAP明显低于术前（P〈0．05），D组摆体位后2min、健侧单肺通气（OLV）10min及OLV 30min的MAP低于P组，但两组比较差异无统计学意义；P组患者HR、MAP无明显变化；两组患者拔管时间、拔管后5min镇静评分比较差异均无统计学意义。结论 瑞芬太尼复合丙泊酚或瑞芬太尼复合地氟烷用于电视胸腔镜手术麻醉，术后苏醒迅速，苏醒质量优良；但在血流动力学方面，前者更加平稳。

Ohjective To assess the anesthesia efficacy of remifentanil-propofol or remifentanil-desflurance in patients undergoing video-assisted thoracoscopic surgery （VATS ）. Methods Forty ASA Ⅰ - Ⅱ patients, undergoing VATS were randomly divided into remifentanil-propofol group （group P, n = 20） and remifentanil -desflurance group （group D, n = 20）.MAP and HR were monitered during the entire procedures. Conscious recovery, spontaneous breathing recovery, the endotracheal extubation time and OAAS score were recorded and compared between two groups. Results During the operation, MAP was decreased significantly in group D （P 〈 0.05）. There was no significant difference in conscious recovery, spontaneous breathing recovery, the endotracheal extubation time and OAAS score between two groups. Conclusions The anesthesia efficacy of remffentanil-propofol or remifentanil-desflurance in patients undergoing VATS were both with quick recovery, but the fronter has more stable hemodynamics.