摘要
目的比较瑞芬太尼复合异丙酚与常规静吸复合全静脉麻醉在听小骨重建中的麻醉效果。方法听小骨重建患者40例,ASAⅠ～Ⅱ级,随机分为对照组和实验组,各20例。两组均以芬太尼、咪唑安定、阿曲库安、异丙酚诱导麻醉,行气管内插管,机械通气。实验组以瑞芬太尼0.1μg～0.5μg/kg/分钟和异丙酚5mg～8mg/kg/小时静脉维持;对照组以异氟醚笑气吸入维持。于入室、气管插管后10分钟、切皮时、使用电钻时、手术中及拔管时分别记录血压,心率;手术结束记录拔管时间、睁眼时间、自主呼吸恢复时间,以及清醒程度、呛咳程度、手术视野清晰度。结果①实验组收缩压、舒张压在气管插管后10分钟、切皮时、使用电钻时及手术中均低于术前,至拔管时恢复到术前水平,心率在术中各观察点与术前均无显著差异;对照组收缩压、舒张压及心率在切皮时、使用电钻时、手术中及拔管时均显著高于术前。两组比较在切皮时、电钻使用时及拔管时,对照组血压、心率均明显高于实验组;②实验组术毕呼吸恢复时间、睁眼时间和拔管时间均短于对照组;③清醒程度和视野清晰度实验组好于对照组;④呛咳程度两组无显著差异。结论瑞芬太尼复合异丙酚全静脉麻醉用于听小骨重建术中血流动力学平稳,患者苏醒快且安静平顺,清醒完全,对保证手术成功起了重要作用。
OBJECTIVE To compare the effect ofRemifentanil-Propofol and Isoflurane-N2O anesthesia onpatients with tympanoplasty with prosthesis implant.METHODS Forty patients scheduled for tympanoplastywith prosthesis implant ( PORP or TORP) were ran-domly divided into two groups according to differentanaesthesia: test group(Remifentanil-Propofol) and con-trol group(Isoflurane-N2O). All patients were induced byFentanyl, Midazolam, Atracurium and Propofol. Patientsin test group were maintained with Remifentanil (0.2-0.5 μ g/kg/min) and Propofol (5～8mg/kg/hr)intravenously, while those in control group were main-tained with inhaling 1%～2 % Isoflurane and 50% N2O.RESULTS The hemodynamics of the patients were morestable in test group than that in control group; The re-covery time of respiration, the time of opening their eyesand extubation were shorter in test group than that incontrol group; The level of awakeness was much betterin test group; The visibility of surgical field in test groupwas better than that in control group. CONCLUSIONThe anaesthesia with Remifentanil and Propofol intra-venously is an ideal anaesthesia method in tympano-plasty with prosthesis implant.
出处
《中国耳鼻咽喉头颈外科》
北大核心
2005年第6期363-365,共3页
Chinese Archives of Otolaryngology-Head and Neck Surgery
