胸科手术中瑞芬太尼复合丙泊酚全凭静脉麻醉的临床观察

目的探讨瑞芬太尼复合丙泊酚全凭静脉麻醉（TIVA）在胸科手术中应用的临床意义。方法选择择期胸科手术（肺叶切除术和食管癌根治术）患者60例,随机分成两组：枸橼酸芬太尼复合丙泊酚TIVA（F组）;瑞芬太尼复合丙泊酚,TIVA（R组）。持续有创监测桡动脉血压,记录平均动脉压、麻醉药物用量以及术毕清醒情况。结果所有患者术中生命体征维持平稳、R组清醒拔管时间和恢复室停留时间明显比F组缩短（P〈0．01）,两组在拔管后均未发生呼吸抑制致SpO2下降。R组有23例、F组有2例拔管后立即述伤口疼痛、烦躁。结论胸科手术中运用瑞芬太尼复合丙泊酚TI-VA时,生命体征维持平稳,术毕停药后清醒迅速,不易发生后遗呼吸抑制作用,但患者伤口疼痛和烦躁明显。

The clinical observaton of remifentanil combined with prpofol for total.intravenous anesthesia during thoracic surgery

Objective To investigate clinical significant effect of remifentanil combined with propofol for total intravenous anesthesia（TIVA ）during thoracic procedures. Methods Sixty cases of thoracic procedures（pneumonectomy and radical operation of esophagical carcinoma）were randomly divided into two groups： Fentanyl combined with propfol（F group）and remifentanil combined with propofol（R group）. Confinous blood pressure was gained through radial artery eannulization.Mean pressure was recordedforevery case,also,dosage of anesthetics and post-operfion awakeness. Restdts All case experienced stable vital signs during surgical procedures. Time of extubation and stay time in recovery room was significantly shorter in R grouup than that in F group（ P 〈 0.01 ）. Pulse oxygen saturation（SpO2） hadn＇ t declined and respiratory function not suppressed after extubation in the two groups.23 case in R group and 2 case in F group experienced incisional wound pain and dysphoria, fight after extubation. Condusion It was observed that the patients experienced steady vital signs, quick awakeness and no sequent respiratory suppression through remifentanil combined with propofol for total intravenous anesthesia（TIVA） during thoracic procedures, otherwise, the Patients experienced incisional wound pain and dysphoria fight after surgical procedures.