瑞芬太尼复合丙泊酚麻醉在颅脑手术中的临床应用

目的探讨瑞芬太尼复合丙泊酚在颅脑手术麻醉中应用的临床价值。方法 60例ASAⅠ或Ⅱ级全麻下择期手术患者,随机分为瑞芬太尼组(Ⅰ组)和芬太尼组(Ⅱ组),麻醉诱导静脉注射咪唑安定+维库溴铵+丙泊酚+芬太尼,麻醉维持Ⅰ组采用持续泵注瑞芬太尼+丙泊酚,Ⅱ组采用间断推注芬太尼+持续泵注丙泊酚,观察并记录两组患者诱导前、切头皮后、钻颅骨时、拔管即刻的血压、心率变化,以及苏醒时间、定向力恢复时间和拔管时间。结果两组患者术中血压、心率与诱导前比较明显降低(P0.05);与Ⅰ组比较,Ⅱ组切头皮后、钻颅骨时血压、心率明显升高、增快(P0.05);两组苏醒时间、定向力恢复时间和拔管时间比较差异无统计学意义。结论瑞芬太尼相对于芬太尼其麻醉平稳、血流动力学稳定,用于颅脑手术中全身麻醉更具优势。

Application of anesthesia with reminfentanil and propofol in craniocerebral operation

Objective To investigate the clinical value of reminfentanil and propofol in craniocerebral operations.Methods Sixty cases of patients in ASA degree Ⅰ-Ⅱ which need endotracheal anesthesia in operating,were randomly divided into two groups ： the reminfentanil group（groupⅠ） and the fentanyl group（groupⅡ）.Induction of anesthesia was used by intravenous injection with midazolam,vecuronium,propofol and fentanyl,and maintenance of anesthesia was kept by pouring with reminfentanil and propofol in group Ⅰ,but the group Ⅱwas used fentanyl discontinually.Changes of blood pressure,heart rate and anesthesia palinesthesia were observed and recorded continuously during every period of operation.Results compared with the T1,blood pressure and heart rate of the two groups at T2 and T3 were both lower respectively;while cutting scalp and diamonding skull,compared with the groupⅠ,blood pressure and heart rate were increased in groupⅡ.There was no difference about the recovery time,orientation recovery time and extubation time.Conclusion Reminfentanil could be more efficient than fentanyl inendotracheal anesthesia of craniocerebral operations