瑞芬太尼芬太尼及瑞芬太尼复合全麻对照探究

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1、瑞芬太尼芬太尼及瑞芬太尼复合全麻对照探究作者：周清河肖旺频姚明安尔丹杜炎芳【摘要】目的对比研究瑞芬太尼、芬太尼复合瑞芬太尼在全麻术中应用的可行性和有效性。方法ASAI〜II级腹部胃肠道手术患者60例随机分为三组：F、R组和RF组，每组20例。F组血浆靶控芬太尼术中镇痛，芬太尼血浆靶浓度根据手术刺激调整，手术结束前半小时停止；R组用瑞芬太尼替代芬太尼；RF组瑞芬太尼复合芬太尼，胃肠道吻合操作気成前主要由芬太尼维持镇痛，其后主要由瑞芬太尼维持镇痛。结果R组诱导时发生呛咳、肌肉强直、心动过缓均比其余两组多。R组苏醒期MAP和HR与其余两组相比明显增高(P<；0.05)o苏醒期R组发生躁动、高

2、血压、心动过速均比其余两组增多明显。与F组相比，R和RF组拔管时间、出恢复室时间明显缩短(P<；0.05)oRF组瑞芬太尼用量与R组相比明显减少(P<；0.05),RF组芬太尼用量与F组相比明显减少(P<；0.05)oR、RF组的拔管后即刻、离开PACU、拔管后lhOAA/S评分明显比F组高(P<；0・05)。RF组患者拔管后即刻、离开PACU时疼痛评分与R组相比，差异显著(P<；0.05)o结论三种麻醉方法术中均能提供良好的镇痛，满足手术要求。但瑞芬太尼联合芬太尼既能提供完善的镇痛，维持术中血流动力学平稳，术毕又能苏醒迅速且苏醒质量高。【关键词】芬太尼瑞芬太尼全身麻醉

3、靶控输注[Abstract】ObjectiveTomakeacomparativestudyonthefeasibilityandvalidityofusingremifentanilsfentanylandremifentanilingeneralanaesthesia・Methods60ASAclassI〜Ilpatientsundergoingabdomenoperationswererandomlydividedintothreegroups：groupF、groupRandgroupRFwith20casesineachgroup.IngroupF,analgesiawasind

4、ucedandmaintainedwithTCIfentanyl.Thetargetplasmaconcentrationoffentanylwasadjustedbasedonoperationstimulationandstoppetat30minbeforetheendofsurgery.InGroupR,fentanylwasreplacedbyremifentanil.InGroupRF,analgesiawasinducedandmaintainedwithTCIremifentanil-fentanyl,analgesiawasmaintainedwithfentanylbe

5、foregastrointestinaltractanastomosisandwithremifentanilafterwards・ResuItsTheoccurrenceofcough、muscletwitch、bradycardiaingroupRweremorethanothertwogroupsduringinducement.MAPandHRingroupRweresignificantlyhigherthanothertwogroupsduringrecoveryfromanesthesia(P<；0.05)・Theoccurrenceoffidget、hypertensi

6、on、tachycardiaweremorethanothertwogroupsduringrecoveryfromanesthesia(P&It；0.05).ThedurationfromterminationofanesthesiatotracheaextubationandthestayinPACUwassignificantlyshorteringroupRandgroupRFthaningroupF(P&It；0.05)・ThequantityofremifentanilusedingroupRFwassignificantlylowerthaningroupRandthequa

7、ntityoffentanylusedingroupRFwassignificantlylowerthaningroupF(P&It；0.05)・TheOAA/SscoresweresignificantlygreateringroupRandgroupRFthaningroupFatthetimepointoftracheaextubation、leavingPACUandlhaftertracheaextubatio