瑞芬太尼、芬太尼对过度肥胖患者麻醉效果及麻醉复苏质量的影响

目的 探讨芬太尼和瑞芬太尼对于肥胖患者全身麻醉效果及复苏的影响,探索联合应用两种药物的可行性,并找到较为可行的联合方式.方法 按随机区组设计将实施全身麻醉的肥胖患者分为4组,每组20例,分别是芬太尼组(F组),瑞芬太尼组(R组),芬太尼复合瑞芬太尼l组(RF1组)和芬太尼复合瑞芬太尼2组(RF2组),比较4组患者的全身...

The effect of remifentanil and fentanyl on anesthesia effect and postoperative recovery in obese patients

Objective Our main objective was to compare the effects of fentanyl and remifentanil on anesthesia and postoperative recovery in obese patients,and to explore the influence of combination of the two drugs.Methods 80 obese patients undertaking general anesthesia were randomly divided into four groups(n=20) Group F(fentanyl ),group R (remifentanil),group RF1 (fentanyl + remifentanil for induction and fentanvl during maintenance) group RF2( fentanyl + remifentanil for induction,and remifentanil during maintenance).Heart rate,mean arterial pressure(MAP),the level adrenocorticotropic hormone (ACTH),time to extubation,time to eyes opened,OAA/S score and visual analog scale (VAS) score were recorded.Results MAP and ACTH in group R (63±7) mm Hg( 1 mm Hg=0.133 kPa),(8.8±2.5) pmol/L) ],group RF2 (64±9) mm Hg,(8.5±2.8) pmol/L] were lower than that of group F (69±10) mm Hg,(10.8±2.6) pmol/L] (P＜0.05) after induction.Time to extubation,time to eyes open and orientation after anesthesia in group R (14.9±1.9,12.0±1.7 and 15.4±2.3),group RF2 (16.3±3.4,15.7±1.4 and 12.6±1.1) were shorter than group F(22.7±1.7,14.8±1.6 and 30.0±3.8) (P＜0.05).The OAA/S score of group R(3.5±0.7) and group RF2(3.5±0.8)1 h after drug discontinuance were higher(P＜0.05) than that of group F(2.2±0.8).The quality of recovery in group R and RF2 were better.But the VAS score of group R 1 h(5.3±1.0),3 h(5.3±0.8) after drug discontinuance were higher(P＜0.05 )than group F(2.3±0.6,2.9±0.6).There is no significant difference between the VAS score of group RF2 and group F (P＞0.05).Conclusion Combined of fentanyl and remifentanil is safe and effective in general anesthesia,also achieves high quality of recovery.