全凭静脉与吸入全身麻醉苏醒期躁动发生率的临床观察

目的比较丙泊酚、地氟烷、七氟烷复合瑞芬太尼全身麻醉苏醒期躁动的发生情况。方法90例ASAⅠ～Ⅱ级择期全身麻醉下行乳腺癌根治术及鼓室成形术。随机分成三组：丙泊酚组、地氟烷组、七氟烷组。观察各组苏醒期躁动发生率和睁眼时间、拔管时间，监测躁动发生前后血压、心率及脉搏血氧饱和度。结果地氟烷组和七氟烷组苏醒期躁动发生率分别为31．03％和33．33％，高于丙泊酚组的3．33％（P〈0．05）；睁眼时间、拔管时间差异不具有显著性意义（P〉0．05）；躁动发生前后血压、脉搏血氧饱和度差异无显著性意义（P〉0．05），而心率在躁动发生后明显增快（P〈0．05）。结论地氟烷、七氟烷吸入麻醉苏醒期躁动发生率明显高于丙泊酚全身麻醉。

Emergence agitation after total introvenus or inhalation anesthesia for maintenance with remifentanil

Objective To evaluate the effect of propofol,desflurane and sevoflorane on emergence agitation.Methods Ninety patients scheduled for radical operation of mastocarcinoma and tympanoplasty procedure were enrolled in this prospective study.The 90 patients under general anesthesia were randomly divided into three groups.After propfol induction,patients were randomly assigned to receive remifentanil with desflurane,sevoflurane or propofol anesthesia for maintenance.We compared the incidence of emergence agitation,eye-open time,extubation time,and BP,HR,SpO2 during emergence agitation.Results Patients who received desflurane and sevoflorane suffered more incidence than propofol(31.03%,33.33%vs3.33%) open-eye time and extubation time were showed no significant variance among the three groups.After restlessness,BP and SpO2 didn't vary significantly compared to pre-agitation values,while HR increased significantly associated with restlessness.Conclusion The association of propofol and remifentanil for anesthesia maintenance resulted in a lower incidence of postoperative agitation compared with the association of desflurane or sevoflurane and remifentanil.