异丙酚复合瑞芬太尼与七氟烷复合芬太尼对斜视术后麻醉恢复的对比研究

Comparison of propofol-remifentanil and sevoflurane-fentanyl anesthesia in recovery from general anesthesia following strabismus surgery

目的比较异丙酚复合瑞芬太尼与七氟烷复合芬太尼对全麻术后快速动眼运动恢复时间的影响。方法60例成年患者，随机分为两组，每组30例。R组（异丙酚复合瑞芬太尼）用异丙酚复合瑞芬太尼进行诱导及麻醉维持，S组（七氟烷复合芬太尼）用异丙酚及芬太尼诱导，七氟烷维持麻醉。麻醉停药后开始每2分钟评价麻醉恢复程度。至患者可行快速动眼运动为恢复时间，麻醉恢复后开始进行眼科评价。结果快速动眼运动平均恢复时间，R组短于S组[（14．72±5．10）min比（23．43±5．52）min，P=0．000]，差异有统计学意义。术后S组恶心呕吐发生率高于R组（37％比10％，P=0．037），差异有统计学意义。结论需要进行即时术后眼科评估的斜视手术中，异丙酚复合瑞芬太尼更有优势。

Objective To compare the time to the recovery of saccadic eye movements in patients between propofol-remifentanil and sevoflurane-fentanyl anesthesia. Methods Sixty adult patients undergoing strabismus surgery were randomly assigned to two groups ： Group R （ propofol-remifentanil, n = 30 ） in which patients were performed induction and maintenance of anesthesia by propofol-remifentanil and Group S （sevoflruane-fentanyl, n = 30 ） in which patients were performed induction by propofol-fentanyl and maintenance of anesthesia by sevoflruane. Recovery from anesthesia was measured from the time when all anesthetics were turned off and was assessed every 2 mix. Recovery time was attained when patients were able to generate brisk saccadic eye movements. At recovery time the ophthalmic evaluation was started. Results The mean recovery time of saccadic eye movements was significantly shorter in the Group R compared to the Group S[ （ 14.72 ±5.10） mix vs （23.43 ± 5.52） min, P = 0.0001. More patients in Group S experienced nausea and vomiting postoperatively as compared to Group R （ 37% vs 10% , P = 0. 037 ）. Conclusions Propofol-remifentanil anesthesia is a better technique in strabismus surgery when immediate postoperative ophthalmic evaluation is desired.