颅内动脉瘤介入术全静脉复合麻醉中应用瑞芬太尼的分析

Application of Remifentanil in Total Intravenous Anesthesia for Intracranial Aneurysm Intervention

目的观察异丙酚、瑞芬太尼全静脉麻醉在颅内动脉瘤介入术的麻醉效果。方法选择ASA分级I～Ⅱ级颅内动脉瘤患者58例,随机分为瑞芬太尼组(R组)、芬太尼组(F组)各29例,记录两组在麻醉诱导及气管插管前后各时段血压、心率、血氧饱和度、呼气末二氧化碳浓度变化、术毕患者自主呼吸恢复时间、睁眼时间、拔管时间、拔管时躁动情况及术后并发症。结果 F组血压、心率值在插管即刻、插管后5min较基础值上升但无显著性差异(P>0.05),R组则下降(P<0.05);两组比较差异显著(P<0.05);两组麻醉维持阶段循环血流动力学稳定,R组术后自主呼吸恢复时间、睁眼时间、拔管时间均明显短于F组(P<0.05)。结论异丙酚和瑞芬太尼全静脉麻醉诱导平稳,血流动力学稳定,麻醉效果优于芬太尼。

Objective To observe the effects of remifentanil in total intravenous anesthesia for intracranial aneurysm intervention. Methods Fifty-eight cases ASA Ⅰ～Ⅱ undergoing intracranial aneusm intervention were randomly divided into two groups：Remifentanil group （R）and Fentanyl group （F）29 cases.in esch The change of blood pressure,heart rate,oxygen saturation of functional hemoglobin （SpO2）,end expiration CO2 were observed;and the time of spontaneously breathing,eyes opening and restlessness at extubation,and postoperative complications at anesthesia induction and tracheal extubation WBS also were recorded. Results There was no significant difference at tracheal intubation immediately after anesthesia induction and 5mins after tmcheal intubation in F group （P〉0.05）,but it was opposite in group R （P〈0.05）. The time of spontaneously breathing recovery,eyes opening,extubation was obviously shorter in R group than that in F group （P〈0.05）. Conclusion Propofol and remifentanil with total intravenous anesthesia are more stable during anesthesia induction,its hemodynamics is more steady palinesthesia is better and it＇s effects is superior to Fentanyl.