瑞芬太尼控制性降压在肝脏部分切除术中的疗效观察

目的观察丙泊酚和瑞芬太尼复合麻醉在肝脏部分切除术中控制性降压的效果与可行性。方法选择单纯肝脏部分切除术患者60例,随机分为:瑞芬太尼降压组(Ⅰ组,n=30)和硝普钠降压组(Ⅱ组,n=30),对降压前后及降压期间的血流动力学变化和PETCO2进行监测以观察降压效果及血压恢复情况进行对比。结果两组的控制性降压效果满意,Ⅱ组控制性降压期间,HR明显增快,出血量相对增多,停用硝普钠后可致HR升高和MAP反跳。而I组控制性降压平稳,停用瑞芬太尼后血压自然恢复至术前水平,无"反跳"现象。降压期间HR明显减慢外,CVP、SpO2、PETCO2等均无明显变化。结论瑞芬太尼在肝脏部分切除术中的控制性降压效果确切,且出血量相对更少而且更安全、易于掌握。

Objective To investigate the effects of controlled-hypotension induced by combination of propofol and remifentanil in patients undergoing part resection of liver.Methods 60 patients undergoing part resection of liver were randomly divided into remifentanil group（group Ⅰ,n=30） and nitroprusside group（group Ⅱ,n=30）.In both groups,the change of hemodynamics and PETCO2 were monitored.Results In both group,good controlled-hypotension efficiency was obtained.Compared with group Ⅰ,heart rate and blood losing were significantly increased in group Ⅱ during controlled-hypotension（P0.05）.Increase in heart rate and rebound hypertension was observed following sodium nitroprusside infusion in group Ⅱ.The heart rate and blood pressure were stable following remifentanil infusion in group Ⅰ.Conclusion Remifentanil is safe,effective and reliable for controlled-hypotension in patients undergoing part resection of liver.