瑞芬太尼复合丙泊酚麻醉在胃癌根治术中的临床观察

目的:评价瑞芬太尼复合丙泊酚在胃癌根治术中的临床效果及安全性,并与芬太尼复合丙泊酚比较。方法:选择ASAⅠ～Ⅱ级行胃癌根治术病例40例,随机分成R组(瑞芬太尼)和F组(芬太尼)各20例。常规麻醉诱导后,麻醉维持R组瑞芬太尼0.25μg/kg/min,F组芬太尼0.05μg/kg/min,两组均丙泊酚100~200μg/kg/min持续静脉输注。观察麻醉诱导前后、气管插管及术中的血压心率变化、睁眼时间、拔除气管导管时间、术后疼痛、术后恶心呕吐情况。结果:两组术中麻醉效果无显著差异,术后复苏均安静;术后睁眼时间、拔除气管导管时间R组明显短于F组;术毕呼吸抑制F组5例,R组无;术后恶心呕吐无差异。结论:在胃癌根治术瑞芬太尼比芬太尼更优越、安全。

The Clinical Observation of Remifentanil combined with Propofol used in Radical Gastrectomy

Objective To evaluate the clinical effect and safety of remifentanil combined with propofol used in radical gastrectomy,and compared with fentanyl.Methods Forty adults ASA I~II patients scheduled for radical gastrectomy were randomly divided into remifentanil group(Group R,n=20) and fentanyl group(Group F,n=20).After inducement of general anesthesia,remifentanil 0.25μg/kg/min infused continuously for maintenance in group R,and fentanyl 0.05μg/kg/min infused continuously for maintenance in group F.Both groups were infused continuously with propofol 100~200μg/kg/min.The changes of blood pressure and heart rate before and after anesthesia induction,tracheal intubation,and during the surgery were recorded and analyzed.The time to eyes opened upon calling and endotracheal extubation were recorded,too.The rate of postoperative pain,nausea and vomiting was observed.Results There was no significant difference in anesthetic efficacy,postoperative recovery,nausea and vomiting between the two groups.The time to eyes opened upon calling and endotracheal extubation in group R were needed significantly less than group F(P<0.01).Five cases were found respiration weakness in group F,and none in group R.Conclusion Compared with fentanyl,remifentanil is more superior and secure for the patients in radical gastrectomy.