雷米芬太尼控制性降压在颅内动脉瘤夹闭术中的应用

Remifentanil for deliberate hypoteusion in intracranial aneurysm clamp operation

目的 探讨颅内动脉瘤夹闭术中雷米芬太尼控制性降压的可行性和安全性。方法 择期行颅内动脉瘤夹闭术患者20例，随机分为两组：雷米芬太尼组（Ⅰ组）和硝普钠组（Ⅱ组）。每组各10例。结果 降压后两组平均动脉压比较差异无统计学意义。降压过程中，两组HR及心肌耗氧量比较差异均有统计学意义（P均〈0．01）。Ⅰ组失血量[（479±82）ml]比Ⅱ组[（521±96）ml]明显减少（P〈0．05）。结论 雷米芬太尼与硝普钠相比可达到控制性降压的效果。

Objective To discuss the effects of remifentanil for deliberate hypotension in intracranial aneurysm clamp operation, evaluating the feasibility and safety. Methods Twenty intracranial aneurysm patients undergoing occlusion surgery were prospectively randomized in to two groups： Group I and Group Ⅱ. Group I adopted remifentanil for deliberate hypotension and Group Ⅱ adopted sodium nitroprusside. The data were analyzed with SPSS 11.5 for Windows. Results Deliberate hypotension was achieved at the target mean arterial pressure （ MAP） for remifentanil and nitroprusside respectively. During deliberate hypotension, HR in Group I were lower than that in Group Ⅱ （P〈 0.01 ）.RPP in Group I were lower than that in Group Ⅱ （P 〈 0.01 ）. Blood loss in Group I were lower than that in Group Ⅱ （P 〈 0.05 ）. Conclusion For general anesthesia in intracranial aneurysm clamp operation, using remifentanil for deliberate hypotension is a good choice.