瑞芬太尼与丙泊酚全凭静脉麻醉对开胸手术患者苏醒时间的影响

Effect of awakening time during total intravenous remifentanil-propofol anesthesia to patients with thoracic surgery

目的探讨瑞芬太尼与丙泊酚全凭静脉麻醉对开胸手术患者苏醒时间的影响。方法50例ASAⅠ～Ⅱ级择期行开胸手术患者,随机分为2组,A组(瑞芬太尼与丙泊酚组)25例,术中瑞芬太尼与丙泊酚持续泵入维持麻醉;B组(芬太尼与咪达唑仑组n=25例),术中芬太尼与咪达唑仑持续泵入维持麻醉。术中根据血压及心律的变化调整输注速度,维持血压及心率在基础值±20%范围内。观察患者苏醒时间、拔管时间及警觉/镇静评分(OAA/S)。结果苏醒时间、拔答时间A组与B组比较有著性差异(P<0.05),A组的苏醒时间、拔管时间最短,且术后苏醒质量评分最佳。结论瑞芬太尼与丙泊酚持续输注维持全凭静脉麻醉由于开胸手术,苏醒最快、质量最佳。

Objective To study the effect of awakening time during total intravenous remifentanil - propofol anesthesia to patients with thoracic surgery. Methods Fifty patients ASA （ I -Ⅱ） scheduled for thoracic surgery were randomly divided into two groups ： for gxoup A, （ remifentanil and propofol, n = 25 ）, Operation during the maintenance of anesthesia with remifentanil and propofol continuous infusion and group B（ fentanyl and midazolam, n = 25 ）, during the maintenance of anesthesia with fentanyl and midazolam continuous infusion. Operation duTing according to changes in blood pressure and cardiac rhythm adjustment infusion rate, blood pressure and heart rate within ±20% range of basic value. The time of awakening, extubation, and the alertness/sedation score（OAA/S） were recorded. Results In two groups, awakening time and extubation time were of significant difference. The awakening and extubation time in group A was shorter than groups B. The awakening quality in group A was the better than group B. Conclusions Remifentanil and propofol continuous infusion of total intravenous anesthesia in the patients with thoracic surgery may have the awakening time and the best quality on analepsia.