瑞芬太尼联合异丙酚麻醉对患者眼内压的变化影响

The Effect of Remifentanil and Propofol on Intraocular Pressure

目的:探讨不同靶浓度瑞芬太尼复合异丙酚麻醉对患者眼内压的影响。方法:88例患者随机分为四组,A、B、C组采用瑞芬太尼联合异丙酚全麻,D组采用芬太尼复合异丙酚,A、B、C三组的瑞芬太尼靶浓度分别为2μg/mL、4μg/mL、6μg/mL,对不同时期四组患者眼内压(IOP)、动脉压(MAP)及心率(HR)测定,并分析对比结果。结果:与D组患者比较,A、B、C三组患者在气管插管前IOP明显降低(P<0.05),但该三组间比较差异无统计学意义(P>0.05);A组患者气管插管5min后的IOP与全麻前比较明显降低(P<0.05),与气管插管前比较明显升高(P<0.05);B、C组患者于气管插管前测定MAP较全麻前明显下降(P<0.05),A组患者气管插管后5min与气管插管前相比MAP明显上升(P<0.05);B、C组患者于气管插管前所测HR比全麻前明显下降(P<0.05),A组患者气管插管后5min与气管插管前比较HR明显上升(P<0.01)。结论:瑞芬太尼复合异丙酚是目前临床较为理想的全凭静脉麻醉的药物搭配,浓度为4μg/mL、6μg/mL的瑞芬太尼联合异丙酚麻醉治疗具有较好的控制眼内压作用,适合于临床推广。

Objective： To discuss the effect of different target concentration of remifentanil and propofol on intraoeular pressure. Method： 88 patients were randomly divided into four groups. Patients in group D were anesthetized with fentanyl and propofol, and patients in group A, B, C were treated with remifentanil and propofol of different target concentration as 2 μg/mL,4 μg/mL,6 μg/mL. Then checked lOP, MAP, HR of the 4 groups in different time. Result： The lOP before intubation in group A, B, C were significantly lower than that in group D （ P〈0.05 ）, but the data in group A, B, and C had no significant difference （ P〉0. 05 ）. The group A lOP in 5 minutes after intubation was significantly lower than that before anesthesia （ P〈 0.05 ） , and it was significantly higher than that before intubation { P〈0.05 ）. The MAP and HR before intubation in group B and C were significantly lower than that before anesthesia （P〈0.05 ） , and MAP and HR in group A of 5 minutes after intubation were significantly higher than that before intubation. Conclusion： Remifentanil and propofol are the ideal clinical drugs with total intravenous anesthesia, and the target con- centration of4μg/mL or 61μg/mL has good control effect for intraocular pressure, which is suitable for clini- cal practice.