甲状腺切除手术中瑞芬太尼联合异丙酚的麻醉效果分析

Analysis of anaesthesia effect of remifentanil combined with propofol during thyroidectomy

目的观察并分析甲状腺切除手术中应用瑞芬太尼联合异丙酚的麻醉效果。方法 60例行甲状腺切除术的患者,随机分为观察组与对照组,每组30例。两组均采用气管插管全身麻醉(全麻),观察组患者采用瑞芬太尼联合异丙酚的维持麻醉,对照组采用异丙酚追加芬太尼维持麻醉,对两组患者的临床麻醉效果进行观察与对比。结果观察组患者清醒时间、呼吸恢复时间、呼之睁眼时间、Steward苏醒评分≥4分时间以及拔管时间均明显短于对照组,差异均具有统计学意义(t=4.0186、4.8264、10.7961、50.1612、7.2184,P<0.05)。对照组患者7例发生咳嗽,另有18例发生拔管时躁动,不良反应发生率为83.33%(25/30);观察组患者2例发生咳嗽,另有8例发生拔管时躁动,不良反应发生率为33.33%(10/30);观察组患者不良反应发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论对甲腺切除术患者采用瑞芬太尼联合异丙酚的麻醉方式,能有效体现出临床的麻醉效果,降低了不良反应的发生率,具有显著的价值意义,值得在临床麻醉领域规范推广与采纳。

Objective To observe and analyze the anaesthesia effect of remifentanil combined with propofol during thyroideetomy. Methods A total of 60 patients with thyroidectomy were randomly divided into observation group and control group, with 30 cases in each group. Both groups received general anesthesia with tracheal intubation, and the observation group received remifentanil combined with propofol to maintain anesthesia. The control group received propofol supplemented with fentanyl to maintain anesthesia. The clinical anaesthesia effect in two groups was observed and compared between two groups. Results The observation group had obviously shorter awake time, respiration recovery time, eye opening time upon calling, Steward wake score ~〉 4 points time and extubation time than the control group, and their difference was statistically significant （t=4.0186, 4.8264, 10.7961, 50.1612, 7.2184, P〈0.05）. The control group had 7 cough cases and 18 restless extubation cases, with incidence of adverse reactions as 83.33% （25/30）. The observation group had 2 cough cases and 8 restless extubation cases, with ineidence of adverse reactions as 33.33% （10/30）. The observation e group had obviously lower incidence of adverse reactions than the control group, and the difference was statistically significant （P〈0.05）. Conclusion Combined anaesthesia of remifentanil and propofol for patients with thyroidectomy can effectively reflect the clinical anesthetic effect and reduce the incidence of adverse reactions. It has significant value and is worthy of promotion and adoption in the field of clinical anesthesia.