瑞芬太尼复合异丙酚全凭静脉麻醉对围拔管期的心血管反应的临床观察

目的观察瑞芬太尼复合异丙酚全凭静脉麻醉对围拔管期患者的心血管反应。方法 60例择期行腹部手术的患者,随机分为全凭静脉麻醉组和七氟醚对照组。分别记录术前、瑞芬太尼＋异丙酚停药时、拔管前即刻、拔管后5m in内血压、心率数值;记录异丙酚停药至拔管的时间;记录乌拉地尔、艾司洛尔等血管活性药物的用量;结果两组间拔除气管导管时间变化无统计学意义;艾司洛尔、乌拉地尔的使用量全凭静脉麻醉组少于对照组,SBP、DBP、HR两组相比无显著性差异。结论全凭静脉麻醉在全麻拔管期可减轻心血管应激反应,且不影响麻醉恢复时间,对合并心脑血管病人有利。

Clinical observation of cardiovascular response by Remifentanil combined with Propofol on tracheal extubation stage during TIVA

Objective: To observe the cardiovascular effects of Remifentanil combined with Propofol on tracheal extubation stage during TIVA(total intravenous anesthesia).Methods: Sixty patients undergoing selective operation on abdominal region were randomly divided into TIVA group(n=30) and sevoflurane control group(n=30).BP(blood pressue) and HR(heart rate) were recorded before operation,at propofol discontinuance,just before extubation and 5 minutes within extubation respectively;the duration was recorded from propofol discontinunance to tracheal extubation;the dose of Urapidil and Esmolol and other vasoactive agent should also be noted.Results:There was no statistical significance in time for extubation,and no significant difference in SBP,DBP and HR between the two groups.The usage of Urapidil and Esmolol in TIVA group was less than sevoflurane control group.Conclusion: It is safe and feasible to use TIVA on cardiovascular patients,and TIVA can relieve the cardiovascular effects during tracheal extubation with no influence on duration of recovery.