丙泊酚复合瑞芬太尼全凭静脉或地氟醚平衡麻醉对听神经瘤手术后苏醒的影响

Effect of propofol-remifentanil total intravenous anesthesia or desflurane-remifentanil anesthesia on emergency in acoustic neuromas resection

目的观察丙泊酚复合瑞芬太尼全凭静脉或地氟醚平衡麻醉对听神经瘤手术后苏醒的影响。方法40例ASAⅠ~Ⅱ级择期行乙状窦入路或颅中窝入路听神经瘤手术的成年患者,随机分为丙泊酚复合瑞芬太尼组(PR组,n=20)和地氟醚平衡麻醉组(DR组,n=20)。记录患者一般情况;记录唤醒时间、拔除气管导管时间和定向力恢复时间;记录2组患者手术结束时的麻醉深度、肌肉松弛恢复情况、拔管时心率和血压变化;记录术后不良事件。结果PR组唤醒时间早于DR组2.4 min(P=0.033);PR组拔除气管导管时间短于DR组4.9 min(P=0.002);PR组定向力恢复时间短于DR组23.7 min(P=0.049);PR组拔除气管导管时血压和心率变化均小于DR组(P<0.05)。结论丙泊酚复合瑞芬太尼全凭静脉麻醉用于听神经瘤手术利于患者术后快速苏醒,地氟醚组患者拔管时心率和血压变化较明显。

Objective To evaluate the effect of propofol and remifentanil total intravenous anesthesia vs desflurane and remifentanil balanced anesthesia on emergency in patients undergone acoustic neuromas resection.Methods Forty ASAⅠ~Ⅱadult patients who had undergone elective sigmoid sinus approach or cranial fossa approach acoustic neuromas resection were randomly divided into two groups:propofol and remifentanil group(group PR,n=20),desflurane and remifentanil group(group DR,n=20).Time from end of the anesthesia to response to verbal call,extubation,and resume of orientation were recorded.The mean arterial pressure(MAP)and heart rate(HR)were recorded on extubation.Results Time to response to verbal call in group PR was 2.4 min,shorter than group DR(P=0.033).Time to extubation in group PR was 4.9 min,shorter than group DR(P<0.002).Time to resume of orientation was 23.7 min shorter than group DR(P=0.049).Changes of MAP and HR between two groups were less in PR group(P<0.05).Conclusions Compared with desflurane and remifentanil anesthesia,propofol and remifentanil anesthesia for adult patients undergone acoustic neuromas resection was associated with fast emergency.