雷米芬太尼与芬太尼在老年患者麻醉中的比较研究

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1、雷米芬太尼与芬太尼在老年患者麻醉中的比较研究张福清杨明华林智平林沛艾(福建省肿瘤医院麻醉科福建福州350014)[摘要】目的:为了探讨雷米芬太尼与芬太尼复合丙泊酚在老年患者胸腹部手术中麻醉效果的比较。方法:选择60例老年患者，采用雷米芬太尼复合丙泊酚组(R组)和芬太尼复合丙泊酚组(F组)，以及肌松药顺笨磺酸阿曲库鞍，均通过靶控输注全凭静脉麻醉。记录二组患者麻醉期间血压、心率、血氧饱和度、手术后苏醒时间。结果:二组患者麻醉诱导后收缩压、舒张压降低以及心率减慢比较明显(P<0.05),气管插管时、切皮时R组无明显改变，而F组则有较明显的变化，二组比较(P<0.05)；手术结束后睁眼时和拔管时

2、心率R组明显增快(PV0.05),F组不明显，二组比较(P<0.05)；R组麻醉恢复时患者苏醒较快，舒适，无呼吸再抑制现象，F组麻醉恢复时患者苏醒和呼吸恢复均较慢。结论:雷米芬太尼复合丙泊酚与芬太尼复合丙泊酚相比较，雷米芬太尼麻醉诱导迅速且平稳，停药后苏醒较快，对气管插管耐受性相对较好，适合老年患者手术麻醉。【关键词】雷米芬太尼；芬太尼；丙泊酚；全凭静脉麻醉；靶控输注ComparisonofremifentanilandfentanylinanaesthesiaforgerontaipatientsZhangFu・qing,YangMing・hua,LiZhi-ping,LinPei-a

3、i[Abstract[Objective:Toevaluatedifferenceofanestheticeffectofremifentanilwithpropofolandfentanylwithpropofolbytargetcontrolledinfusion(TCI)forchestandabdomenoperationingerontaipatientsintotalintravenousanesthesia(TIVA).Methods:60gerontaipatientswererandomlydividedintotwogroups:onegroupremifentani

4、lwithpropofol(groupR)andanothergroupfentanylwithpropofol(groupF),andmusclerelaxantcisatracuriumbesilatewasinjectedbytargetcontrolledinfusionduringoperationintwogroups.Thehemodynamicchangespressuresuchasbloodpressure,heartrate,pulseoxygensaturation,postoperationanalepsiatimewereobservedinallpatien

5、ts.Result:SystolicpressureanddiastolicintwogroupsweresignificantlylowerandHRdecreasedafterinductionofanesthesia(P<0.05),andremainedstableaftertrachealintubationandskinincisioningroupRbutchangedingroupF,therewassignificantdifference(P<0.05).HRincreasedsignificantlyingroupRattheendofoperationandatt

6、hetimeofdrawingduct(P<0.05).PatientsingroupRfeltcomfortableduringtherecoveryofanesthesia,norespirationsuppression,andpatientsingroupFrecoveredslower.Conclusions:targetcontrolledinfusionofremifentanilwithpropofolcompareswithfentanylwithpropofolfortotalintravenousinfusionhasadvantagessuchasrapidand

7、stableinduet:ionofaneasthesia,,fastercomeroundafterstopusingthem,relativegoodtolerancetotrachealintubation.Itissuitableforanesthesiaingerontaipatients.[Keywords]Remifentanil;Fentanyl;Propofol;Totalintravenousanesthesia