摘要
目的:观察瑞芬太尼复合异氟醚在神经外科手术中行控制性降压的效果。方法:择期行控制性降压的手术患者50例,随机分为瑞芬太尼组(R组)和硝普钠组(S组),每组25例。R组:以0.2μg/(kg.min)速度开始给予瑞芬太尼,每隔30s增加0.05μg/(kg.min)直到达到目标血压;S组:从1μg/(kg.min)速度开始给予硝普钠,每隔30s增加0.5μg/(kg.min)直到达到目标血压。平均动脉血压(MAP)降低至基础值的60%～70%为目标血压。记录在麻醉前(T0)、控制性降压前(T1)、控制性降压后5min(T2)、控制性降压后30min(T3)、控制性降压结束后20min(T4)MAP、HR、CVP和外科医生的满意程度。结果:S组T2～T4的HR较T0和T1增加;R组T2～T4的HR较T0和T1减慢,也比S组T2～T4的HR慢;S组T4的MAP、CVP较T1高,也高于R组T4的MAP、CVP(P<0.05)。R组的出血量少于S组(P<0.05),外科医生对R组的术野满意程度高于S组(P<0.05)。结论:瑞芬太尼复合异氟醚控制性降压在神经外科手术中手术过程平稳,且可为神经外科手术提供更清晰的术野。
Objective：To investigate the effect of remifentanil-isoflurane-induced controlled hypotension for neurosurgery. Methods：50 patients were randomly assigned into remifentanil group （R group,n = 25）and SNP group （S group,n=25）. In R group, 0.2μg/（kg · min） remifentanil was infused, and in S group,1 μg/（kg · min） SNP was infused. To control MAP to a level of 60% -70% of baseline. MAP,HR,CVPand before anesthesia（T0）,before controlled hypotension （T~）, 5 min（T2）and 30 min（T3）after controlled hypotension,and 20 min after termination of controlled hypotension （T4）and the satisfaction degree of surgeon were recorded. Results：HR got quick in group S,and slower in group R（P〈0.05）during controlled hypotension, in group S, MAP and CVP increased significantly at（T4）,but change not much at（T4）in group R. Blood loss from the surgical field was less in group R than in group S and the satisfaction degree of surgeon was higher in group R （P〈0.05）. Conclusion：remifentanil-isoflurane-induced controlled hypotension is well performed, and provides an ideal operating condition for neurosurgery.
出处
《医药世界》
2009年第2期11-13,共3页
Medicine World
