探讨在游离皮瓣移植术中采用瑞芬太尼复合异丙酚静脉麻醉的效果

To investigate the effect of intravenous anesthesia with remifentanil combined with propofol in free flap transplantation

目的探讨分析在游离皮瓣移植术中采用瑞芬太尼复合异丙酚静脉麻醉的临床效果及安全性。方法选取我院需行下肢游离皮瓣移植术患者78例,按照完全随机的方法分为两组,观察组(R组)采用瑞芬太尼复合异丙酚静脉麻醉,对照组(F组)采用芬太尼复合异丙酚静脉麻醉,观察两组患者麻醉诱导前(T1)、插管后10min(T2)、手术开始(T3)、游离皮瓣时(T4)、术毕(T5)各时段收缩压(SBP)、舒张压(DBP)、心率(HR)变化,并对两组患者停药后呼名睁眼、拔管、准确回答问题时间及术后恶心呕吐发生情况进行对比。结果对照组患者在T2、T3、T4、T5各时段SBP、DBP、HR指标较观察组波动明显,经对比其差异具有统计学意义(P<0.05);其停药后呼名睁眼、拔管、准确回答问题时间长于观察组,其差异具有统计学意义(P<0.05);观察组患者术后出现恶心呕吐患者2例,对照组患者出现恶心呕吐症状6例。结论在游离皮瓣移植术中采用瑞芬太尼复合异丙酚静脉麻醉术中各指标更加平稳,术后苏醒更快、更平稳,适合在临床麻醉中推广使用。

Objective To investigate the clinical efficacy and safety of remifentanil combined with propofol intravenous anesthesia in free flap transplantation.Methods Select the required for patients with lower limb free flap transplantation in78cases in our hospital,randomly divided into two groups,observation group(group R)with remifentanil and propofol intravenous anesthesia,the control group(F group)anesthesia with fentanyl and propofol intravenous anesthesia,observe two groups of patients before induction,after intubation(T1)10min(T2),operation(T3),free flap(T4)and the end of operation(T5)in each period of systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),and the two groups of patients after discontinuation of the name eyes,extubation time and operation,accurate answer questions after comparing the incidence of nausea and vomiting.Results Patients in the control group T2,T3,T4,T5,SBP,DBP,HR in each period compared with the observation group index fluctuates significantly,by comparing their differences were statistically significant(P<0.05);after its withdrawal calling eye opening,extubation,accurate answer time is longer than the observation group,the difference was statistically significant(P<0.05);nausea and vomiting in patients with postoperative observation group2cases,control group patients showed symptoms of nausea and vomiting in6cases.Conclusion During the procedure of free flap transplantation,the indexes of remifentanil and propofol intravenous anesthesia were more stable,faster and more stable.