| 瑞芬太尼用于显微镜下单鼻孔经蝶入路垂体瘤切除术的临床效果 |
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| 引用本文： | 陶德强 梁汉生,杨占民,卢兰生. 瑞芬太尼用于显微镜下单鼻孔经蝶入路垂体瘤切除术的临床效果[J]. 实用医学杂志, 2008, 24(15): 2681-2683 |
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| 作者姓名： | 陶德强 梁汉生 杨占民 卢兰生 |
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| 作者单位： | 北京大学航天临床医学院 航天中心医院 |
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| 摘 要： | 目的：比较瑞芬太尼与芬太尼在单鼻孔经蝶入路垂体瘤切除术麻醉时的优缺点。方法：78例拟行单鼻孔经蝶入路垂体瘤切除术的病人随机分为芬太尼组（F组，31例）和瑞芬太尼组（RF组，47例）。麻醉诱导静注芬太尼3μg／kg（F组）、瑞芬太尼2μg／kg（RF组）、咪唑安定0.1mg／kg、依托咪酯0.3 mg／kg、维库溴铵0.1mg／kg。常规监测。观察sBP、HR、CVP、CCO、CI、AEPex，分别记录诱导前(T1)、插管前(T2)、插管后1min(T3)、凿蝶骨时(T4)、拔管前(T5)、拔管后5min(T6)各项数据，麻醉起效、恢复时间及不良反应。结果：起效、恢复时间RF组小于F组（P﹤0.05）；RF组T3、T4、T5、T6时SBP、HR、CCO、CI波动差异无显著性意义(P﹥0.05)，而F组在T3、T4、T5、T6时差异具有显著性意义（P﹤0.05）；AEPex在T3、T4、T5、T6时两组间差异具有显著性意义（P﹤0.05）；两组均无严重不良反应。结论：瑞芬太尼较芬太尼起效快；消除快，作用强效；心肌抑制作用轻。
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| 关 键 词： | 瑞芬太尼 显微镜 垂体瘤 麻醉 |
| 收稿时间： | 2007-10-26 |
Anesthesia for surgery of pituitary adenomas through single-nostril transsphenoidal approach by remifentanil |
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| Abstract: | Object To Compare remifentanil with fentanyl in anesthesia for surgery of pituitary adenomas through single-nostril transsphenoidal approach .Methods 78 patients of the pituitary adenomas were divided into two groups randomly:groupF(n=31) and groupRF(n=47).Anesthesia was induced with fentanyl 3μg﹒kg-1（groupF）、remifentanil 2μg﹒kg-1（groupRF）、midazolam 0.1mg﹒kg-1 、etomidate 0.3 mg﹒kg-1and vecuronium 0.1mg﹒kg-1.Routine monitoring. To observe sBP、HR、CVP、CCO、CI、SVR、PVR、PCWP、AEPex and sign them before induction（T1）、before endotracheal intubation（T2）、one minutes after endotracheal intubation（T3）、at the time of chisel sphenoidal bone（T4）、before extubation（T5）、five minutes after extubation（T6）.To sign patient,s anesthesia onset、recover time and adverse reaction. Results The patient,s anesthesia onset、recover time in groupRF was shorter than that in groupF（P﹤0.05）；There was no significant difference of sBP、HR、CCO、CI in groupRF at T3、T4 、T5 (P﹥0.05),but was that in groupF at T3、T4、T5、T6（P﹤0.05）；There was significant difference of AEPex between two groups at T3、T4、T5、T6（P﹤0.05）；There was no severe adverse reaction in two groups. Conclusions The time of anesthesia onsetion and recovery with remifentanil is shorter than that of fentanyl；remifentanil has great analgesia effect and its affecting cardiac function is weaker than fentanyl. |
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