氟比洛芬酯对瑞芬太尼-丙泊酚靶控输注静脉麻醉围拔管期反应的效果

Effect of Flurbiprofen axetil on the reaction during the extubation period of remifentanil-propofol target-controlled infusion anesthesia

目的观察氟比洛芬酯、曲马多和芬太尼分别对瑞芬太尼-丙泊酚靶控输注静脉麻醉围拔管期反应的影响。方法60例腹腔镜胆囊切除术患者随机均分为A、B、C三组,麻醉均采用瑞芬太尼-丙泊酚靶控输注静脉麻醉,手术结束前10min,A组静脉注射氟比洛芬酯0.7mg/kg,B组静脉注射曲马多1.4mg/kg,C组静脉注射芬太尼1.4ug/kg。在围拔管期,观察血压、心率、呼吸变化;自主呼吸恢复时间、呼之睁眼时间、拔管时间、定向力恢复时间、麻醉复苏室停留时间;离开复苏室前视觉模拟评分最高分(VAS);围拔管期呛咳、躁动发生率等。结果与术前相比,三组患者在拔管时血压明显升高、心率加快(P<0.05);患者的躁动和呛咳发生率三组间差异无统计学意义;三组呼吸次数差异无统计学意义;患者的自主呼吸恢复时间、呼之睁眼时间、拔管时间、定向力恢复时间、麻醉复苏室停留时间A组较B和C组短(P<0.05),VASC组较A组和B组高,(P<0.05)。结论氟比洛芬酯与曲马多、芬太尼一样能够比较好的抑制瑞芬太尼-丙泊酚靶控输注静脉麻醉围拔管期的不良反应。

objective To observe the effect of flurbiprofen axetil, tramadol, fentanyl on the reaction of remifentanil-propofol target-controlled infusion （TCI） anaesthesia during extubation period. Methods 60 cases of laparoscopie cholecysteetomy patients were randomly divided into A,B,C groups.Remifentanil-propofol-target-eontrolled infusion anesthesia was performed in all groups. At 10 min before the end of operation, flurbiprofen axetil 0.7 mg / kg, tramadol 1.4 mg / kg and fentanyl 1.4 ug / kg were infused introvenonsly in group A,B and C respectively. During the extubation period, blood pressure, heart rate, breathing changes, breathing indepen- dently recovery time,eyes open time, extubation time, the orientation of the recovery time,remaining time in the anesthesia recovery room, visual analogue score （V-AS）, and the incidence of choking and restlessness were recorded. Results Compared with the basic values, in three groups, blood pressure and heart rate increaed significantly （P〈0.05） when extubated. The incidence of choking and restlessness among the three groups had no significant difference. Breathing independently recovery time, eyes open time, extubation time, the orientation of the recovery time, and remaining time in the anesthesia recovery room in group A were shorter than that in group B and C （P〈0.05）, VAS in group C was higher than that in group A and B, （P〈0.05） Conclusion Flurbiprofen axetil also can reduce the adverse reactions of remifentanil-propofol target-controlled infusion anesthesia during the extubation period