瑞芬太尼复合丙泊酚在隆胸术麻醉中的应用

The application of propofol combined with remifentanyl in anesthesia of breast augmentation

目的观察瑞芬太尼复合丙泊酚用于隆胸手术的可行性和安全性。方法选择拟行隆胸手术的患者60例,采用随机信封法将患者分为R组和K组各30例。术前均给予咪达唑仑1 mg和舒芬太尼5μg。R组术中采用瑞芬太尼和丙泊酚持续泵入,K组手术过程中分次给予氯氨酮,同时丙泊酚持续泵入。手术结束前两组均给予曲马多进行术后镇痛。观察比较两组患者的麻醉效果及不良反应。结果 R组丙泊酚用量少于K组,辅助呼吸的发生率高于K组,且恶心呕吐、头晕的发生率较K组低,差异均有统计学意义(P<0.05)。两组术后疼痛评分比较差异无统计学意义(P>0.05)。结论隆胸手术的麻醉中使用瑞芬太尼、氯氨酮均较安全,但复合瑞芬太尼可减少丙泊酚的用量,但就患者的舒适度而言,瑞芬太尼比氯氨酮更具优势。

Objective To observe the feasibility and safety of propofol combined with remifentanil infusion in anesthesia of breast augmentation.Methods Sixty cases undergoing breast augmentation were randomly divided into two groups：Remifentanyl group （R）and Ketamine group（K）,30 in each group.One mg of midazolam and 5 μg of sufentanil were given before operation.In the R group,remifentanyl and propofol were pumped during the operation.In the K group, ketamine was injected several time and propofol were pumped during the operation.All the patients were injected with tramadol for postoperative analgesia just before the end of surger-y.Anesthetic effect and adverse reaction were compared between the two groups.Results Total dose of propofol in the R group was significantly lower（P〈0.05）but incidence of assistant respiration was higher than that than that in the K group.The incidence of nau-sea vomiting and dizziness in the K group was higher than that in the R group（P〈0.05）.There was no significant difference in pain score between the two groups.Conclusion The application of remifentanyl and ketamine is safe during anesthesia of breast augmenta-tion.However,remifentanyl are better than ketamine in term of the patient＇s comfort.