瑞芬太尼和芬太尼在整形美容全麻手术中应用效果的对比性研究

Remifentanil and fentanyl anesthesia in cosmetic plastic surgery in the comparative study of application effect

目的:观察瑞芬太尼和芬太尼在整形美容全麻手术中的应用效果。方法:整形美容手术40例,随机分为两组。PF组为丙泊酚-芬太尼全麻组(n=20),PR组为丙泊酚-瑞芬太尼全麻组(n=20)。记录麻醉前(T0)、插入气管插管前(T1)、插入气管插管即刻(T2)、插入气管插管后(T3)、切皮即刻(T4)、拔出气管插管时(T5)BP、HR、SPO2和PETCO2。记录术毕停药后自主呼吸恢复时间,呼之睁眼时间,拔出气管插管时间;术中出现体动反应、屏气呛咳、恶心呕吐等不良反应发生率等。结果:PF组HR明显快于PR组,SBP明显高于PR组(P<0.05)。PR组患者术毕自主呼吸恢复时间、呼出睁眼时间、拔管时间均短于PF组(P<0.01)。PR组患者不良反应明显少于PF组(P<0.05)。结论:瑞芬太尼复合丙泊酚麻醉用于美容手术能有效维持血流动力学稳定,可控性好,麻醉深度易于调节,术后恢复快,明显优于芬太尼复合丙泊酚麻醉。

Objective To observe the Charui fentanyl and fentanyl anesthesia in cosmetic plastic surgery results.Methods Cosmetic surgery 40 patients were randomly divided into two groups.PF group,propofol-fentanyl anesthesia group（n = 20）,PR group,propofol-remifentanil anesthesia group（n=20）.Recorded before anesthesia（T0）,insert the endotracheal tube before（T1）,immediately insert the endotracheal intubation（T2）,inserted after intubation（T3）,immediate skin incision（T4）,pull out the endotracheal intubation（T5） BP,HR,SPO2,and PETCO2.Record surgery recovery time after treatment of spontaneous breathing,eyes open and call time,pull out the intubation time;intraoperative body movement reaction,choking breath,nausea,vomiting and other adverse reaction rate.Results The PF group was significantly faster than the PR group HR,SBP was significantly higher than the PR group（P0.05）.PR patients surgery recovery time of spontaneous breathing,exhale opening eyes,extubation time was shorter than the PF group（P 0.01）.Adverse reactions in patients with PR group was significantly less than the PF group（P0.05）.Conclusion Remifentanil and propofol anesthesia for cosmetic surgery can effectively maintain hemodynamic stability,good controllability,easy to adjust the depth of anesthesia,postoperative recovery,better than fentanyl and propofol anesthesia.