丙泊酚联合芬太尼、瑞芬太尼用于可弯曲喉罩置管效果的观察与评价

目的:探讨丙泊酚联合芬太尼或瑞芬太尼在功能性鼻内窥镜手术中可弯曲喉罩置管的效果.方法:择期行功能性鼻内窥镜手术(FESS术)患者54例,随机分为芬太尼组(F组)和瑞芬太尼组(R组)各27例,分别静脉注射芬太尼1μg/kg或瑞芬太尼0.5 μg/kg,30 s后注射丙泊酚2.5 mg/kg.结果:两组"下颌松弛度"和"窒息时间'无统计学差异,R组"咳嗽与体动反射"低于F组,F组"首次置管成功率"高于R组,R组"口咽部结构"优于F组.结论:功能性鼻内窥镜手术中丙泊酚联合芬太尼或瑞芬太尼均能为可弯曲喉罩提供良好的置管条件,为手术提供有效、安全的通气,术后不良反应和合并症少.

The Comparison of Fentanyl and Remifentanil to Facilitate the Insertion of the Flexible Laryngeal Airway Mask

Objective： To compare the conditions during insertion of the flexible laryngeal airway mask （FLAM） in patients undergoing FESS received remifentanil or fentanyl before the induction of anesthesia with IV propofol. Method： 54 cases were devised randomly into two groups （Group F and Group R）,each group was 27 cases. 30 seconds before the induction of anesthesia with IV propofol 2.5 mg/kg, patients received fentanyl 1 μg/kg （Group F）, or remifentanyl 0.5 μg/kg （Group R）. Result： There were no difference between two groups in jaw mobility and apnea time. The reflexes during insertion in Group R were less than Group F, and the success rate of Group F was higher than that of Group R. The airway quality of Group R were better than that of Group F. Conclusion： We conclude that both fentanyl 1 μg/kg and remifentanil 0.5 μg/kg, when administered after IV propofol 2.5 mg/kg, provide excellent conditions for insertions of the FLAM with little complication and adverse reaction.