瑞芬太尼在颈椎前路手术中的应用

目的探讨瑞芬太尼在颈椎前路手术中的应用效果。方法90例ASAⅠ-Ⅱ级颈椎前路手术患者，随机分为3组，Ⅰ组为瑞芬太尼组，Ⅱ组为芬太尼组，Ⅲ组为对照组，采用单纯颈丛阻滞，不加中枢性镇痛药。结果Ⅰ组与Ⅱ组患者的疼痛及疼痛反应引起的血压变化与Ⅲ组比较，Ⅲ组收缩压（SBP）明显升高，有显著差异。Ⅰ组与Ⅱ、Ⅲ组患者疼痛及疼痛反应引起的心率增快与Ⅲ组比较，有显著差异，Ⅰ组中有l例心率减漫，但与Ⅱ、Ⅲ组比较无显著差异。Ⅰ组与Ⅱ组、Ⅲ组相比存在明显的呼吸抑制。疼痛语言评分（VRS）Ⅰ、Ⅱ组镇痛效果明显优于Ⅲ组，存在显著差异。结论颈丛阻滞复合瑞芬太尼靶控输注用于颈椎前路是一种安全有效的麻醉方式。

Application of Remifentanil in Patients Undergoing Anterior Cervical Surgery

Objective To study the efficacy of remifentanil for patients with cervical vertebra surgery. Methods Ninety ASA Ⅰ - Ⅱ patients Undergoing anterior cervical surgery under cervical plexus block were divided randomly into three groups： group I （ remifentanil, n = 30）, group II （ fentanyl, n = 30） and group Ⅲ （ control group treated only with cervical plexus block, n = 30）. Results The blood pressure variety from the ache showed that SBP was significantly higher in group Ⅲ than that in group Ⅰ and Ⅱ ,there was significant difference. The heart rate were significantly lower in group Ⅰ than that in group Ⅱ and Ⅲ ,but not between group Ⅱ and Ⅲ, The incidence of respiratory depression was significantly frequent in group Ⅰ than that in other groups. The VRS values were significantly higher in group Ⅲ than that group Ⅰand Ⅱ, Remifentanil and fentanyl provided satisfactory analgesia. Conclusions Cervical plexus block combined with remifentanil by target-controlled infusion provide an effective and safe conditions for anterior cervical surgery.