瑞芬太尼靶控输注镇痛联合表面麻醉在食道异物取出术中的应用

Extraction of Esophageal Foreign Bodies Under Combination of Remifentanil Target-Controlled for Sedation and Superficial Anesthesia in Awake Patients

目的:探讨靶控输注瑞芬太尼联合表面麻醉在食道异物取出术中的安全性和效果。方法:将60例将行食道镜下食道异物取出术的病人随机分成两组,每组各30人,一组(表面麻醉组)先以1%丁卡因5m l作咽喉部喷洒,及2%利卡因10m l含服;二组(瑞芬太尼组)在一组的基础上加用瑞芬太尼靶控输注。分别记录两组患者在麻醉前、麻醉后及术中的HR、SP、DP、MAP、SPO2的变化和VAS评分。结果:一组中有3例病人未能按预定完成手术,二组均能顺利完成手术,术中SPO2均在正常范围内,一组的血流动力学变化显著性差异。结论:瑞芬太尼靶控输注(靶控)镇痛辅助表面麻醉下能显著减轻病人清醒状态下食道异物取出术的心血管反射及病人的不适,能安全地应用于该类患者。

Objective： To evaluate the effect and safety of combination of.remifentemil target - con- trolled infusion for sedation and superficial anesthesia during extracting esophageal foreign bodies in awake patients. Method：60 patients with esophageal foreign bodies divided into two groups randomly. Group A： Superficial anesthesia laryngo pharynx with 1% dicaine 5ml and take 2% lidoeaine 10ml. Operation was carried out . Group B： On the base of method mentioned above, target - controlled infusion of Remifentanil （ blood 2ng/ml ） was employed before operation HR, SP, DP, MAP, SPO2 and VAS of each patient before during and after operation was recorded. Result：There are three patients ease the operation in group A. The other patients were successfully extracted the esop VAS in group A were more significant than that in hageal foreign bodies . The changes of hemodynmics and group B. Conclusion： Combination of remifentail target - controlled infusion for sedation and superficial anesthesia was a safe regimen for extraction of esophageal foreign bodies in awake patients and shown significantly lessen cardiovascular reflex during the period of operation.