不同麻醉配伍方式与苏醒期躁动的关系.pdf

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1、医学l临床研究2013年i1月第3O卷第11期JClinRes，Nov．2013，Vol30，No11·论著·不同麻醉配伍方式与苏醒期躁动的关系张丽峰鲍杨贺广宝史东平一(上海市嘉定区中心医院麻醉科，上海201800)[摘要]【目的】主要探讨静脉麻醉不同配伍方式与苏醒期躁动的关系。【方法】选择静脉全麻下行无痛胃镜检查术的患者300例，随机分为三组：丙泊酚+芬太尼组(PF组)、丙泊酚+瑞芬太尼组(PR组)、丙泊酚+舒芬太尼组(PS组)，各组均100例。记录用药前、用药后、胃镜退出时平均动脉压(MAP)、脉搏氧饱和度(SpO

2、2)，胃镜退出后观察躁动发生情况，并按镇静躁动分级法对其苏醒状况进行评分。【结果】苏醒期躁动的发生率分别为：PR组39(39／100)、PS组11(1l／100)、PF组17(17／100)。PR组与PS组及PF组相比，躁动发生率均显著增高(P≤0．01)，而PS组与PF组相比则无显著差异(P>O．05)。PR组低氧血症发生率(11)明显高于PS组(1)与PF组(2)，差异均有显著性(P

3、伍方式。[关键词]麻醉RelationshipBetweenDifferentCombinedAnesthesiaMethodsandAgitationinRecoveryPeriodZHANGLi—feng，BA0Yang，HEGuang—bao，etal(DepartmentofAPs￡^Ps0z0g，CentralHospitalofJladingDistrictinShanghai，Shanghai201800，China)[Abstract]【Objective]Toexploretherelationshi

4、pbetweendifferentcombinedintravenousanesthesiamethodsandagitationinrecoveryperiod．[Methods]Totally300patientsundergoingpainlessgastroscopyun—derintravenousanesthesiawerechosenandrandomlydividedintopropofol+fentanylgroup(groupPF)，propofol+remifentanilgroup(groupP

5、R)andpropofol+sufentanilgroup(PS)with100patientsineachgroup．Meanarterialpressure(MAP)andpulseoxygensaturation(SpO2)beforeandafteradministrationandatgas—troscopewithdrawalwererecorded．Theincidenceofagitationaftergastroscopewithdrawalwasobserved．Thesedationagitati

6、onclassificationmethodwasusedtoassesstherecoverystatus．[Results]Theincidenceofagi—tationofgroupPR，groupPSandgroupPFinrecoveryperiodwere39(39／100)，11(11／100)and17(17／100)，respectively．ComparedwithgroupPSandgroupPF，theincidenceofagitationingroupPRwassignificantlyi

7、ncreased(P≤0．01)，buttherewasnosignificantdifferencebetweengroupPSandgroupPF(P>O．05)．TheincidenceofhypoxemiaingroupPR(11)wasobviouslyhigherthanthatingroupPS(1)andgroupPF(2)，andthereWSSsignificantdifference(P<0．01)．【Conc1usion】Theincidenceofagitationandhypoxemiain

8、propofol+fentanylgroupandpropofol+sufentanilgroupinrecoveryperiodwerelowerthanthatinpropofol+remifentanilgroup，SOitprovidesagoodcombinedintravenousanesthesiamethod．[K