摘要
目的：比较丙泊酚联合舒芬太尼或瑞芬太尼在神经外科手术中的应用效果。方法：50例行神经外科手术的患者随机分为两组（每组各25例）：麻醉维持时舒芬太尼组予舒芬太尼1.0-1.5μg·kg^-1·h^-1静脉泵注,而瑞芬太尼组予瑞芬太尼9μg·kg^-1·h^-1静脉泵注。两组患者全麻诱导方法相同,麻醉维持时的丙泊酚和阿曲库铵泵注剂量相同。记录两组患者平均动脉压及心率的基础值（T0）,开颅时（T1）、颅内手术时（T2）、关颅时（T3）、拔管时（T4）的平均动脉压和心率值,以及术毕苏醒情况。结果：舒芬太尼组（SF组）和瑞芬太尼组（RF组）在开颅时、颅内手术时、关颅时的平均动脉压和心率均明显低于基础值（P〈0.05）,两组间差异无统计学意义（P〉0.05）。但拔管时RF组平均动脉压及心率明显高于SF组（P〈0.05）,并且高于基础值（P〈0.05）。SF组呼吸恢复及拔管时间长于RF组（P〈0.05）,但仍在较理想范围内,拔管后意识状态（OAAS评分）两组间差异无统计学意义（P〉0.05）。两组均无术中知晓。RF组拔管后疼痛评分（VAS）及躁动发生率高于SF组（P〈0.05）。结论：丙泊酚联合舒芬太尼全凭静脉麻醉在神经外科手术中具有极大的应用价值。
Objective ：To compare the effect of propofol combined with sufentanil or remifentanil in neurosurgery.Methods：Fifty patients undergoing neurosurgery were randomly divided into two groups（25 in each） to receive sufentanil 1.0-1.5μg·kg^-1·h^-1（SF group） or remifentanil 9μg·kg^-1·h^-1 （RF group） respectively during anesthetic maintenance.The methods were same in two groups during induction. The continuous intravenous infusion dose of propofol and atracurium were same in two groups during maintenance of anesthesia.MAP, HR were recorded at baseline, opening and closing skull, during operation or at extubation.VAS and OAAS grades after extubation were evaluated, too.Results： MAP and HR of two groups were lower at opening and closing skull or during operation than those at baseline （P〈0.05）. MAP and HR in RF group were higher than those in SF group at extubation （P〈0.05）,which were higher than those at baseline,too （P〈 0.05）.The respiration recovery time and extubation time in SF group were longer than those in RF group（P〈0.05）, but still in an ideal extent. And OAAS grades after extubation had no significant difference between two groups （P〉0.05）. There was no awareness case in two groups. VAS grades in SF group were lower than those in RF group after extubation （P〈0.05）.Conelusion：Propofol combined with sufentanil total intravenous anesthesia has a great application value in neurosurgcry.
出处
《现代医药卫生》
2009年第24期3692-3693,共2页
Journal of Modern Medicine & Health
