恒速输注瑞芬太尼、丙泊酚在全麻病人苏醒期的临床观察

The observation of patients anesthetized with remifentanil and propofol during the awakening period

目的观察病人恒速输注瑞芬太尼、丙泊酚全麻后苏醒期的表现。方法择期行全身麻醉的手术病人68例，ASAⅠ-Ⅱ级，随机分为两组，每组34人。A组麻醉方法为恒速输注瑞芬太尼、丙泊酚，持续吸入低浓度异氟醚。B组恒速输注咪唑安定，间断推注芬太尼，持续吸人低浓度异氟醚全麻。观察病人麻醉苏醒时间、拔管时间、苏醒期的精神状态、生命体征变化以及气道反应。结果A组病人苏醒时间与拔管时间小于B组（P〈0．05）；苏醒期病人的安静程度A组优于B组（P〈0．05）：吸痰时病人的咳嗽反应A组明显低于B组（P〈0．01）；拔管前后两组生命体征的变化无明显差异（P〉0．05）。结论恒速输注瑞芬太尼、丙泊酚全麻病人在苏醒期具有苏醒快速、平稳，气道反应小，病人舒适度高的特点。

Objective To observate of patients anesthetized with remifentanil and propofol during the awakening period.Methods 68 patiens were randomly divided into two groups.Group A（n=34）：the patients were anesthetized with remifentanil and propofol constantly, combined with low concentration isoflurane.Group B（n=34）： the patients were anesthetized with midazolam constantly , combined with low concentration isoflurane, fentanyl was added at intervals.The awakening time, extubation time, spirit status, the change of vital signs and cough reaction were recorded.Results The awakening time and extubation time of patients in Group A were shorter than that of patients in Group B（P 〈 0.05）.The sedation level of patients in Group A was better than that of patients in Group B（P〈 0.05）. Cough reaction of patiens in Gorup A was much better than that of patients in Group B（P〈 0.01）. There were no significant differences in vital signs before and after extubation among two groups（P〉 0.05）.Conclusion Remifentanil and propofol infused constantly had the advantages of quick and smooth conscious recovery, slight gas tract reaction.The patients were more comfortable.