瑞芬太尼与芬太尼在神经外科麻醉中的比较

目的比较瑞芬太尼与芬太尼在神经外科手术中对麻醉诱导和维持阶段的血流动力学、术后呼吸恢复时间、拔管时间和术后恶心呕吐发生率的影响。方法60例神经胶质瘤的病例随机分为两组，R组使用瑞芬太尼诱导，以丙泊酚和瑞芬太尼分别静脉泵注维持麻醉，F组使用芬太尼诱导，以丙泊酚和芬太尼分别静脉泵注维持麻醉，术中连续监测HR、SpO2、MAP值，并观察术毕呼吸恢复时间和拔管时间以及术后恶心呕吐。结果在麻醉诱导和维持阶段，R组和F组MAP和HR均下降，R组下降幅度大于F组（P〈0．05），气管插管后即刻和切皮时R组麻醉深度明显少于F组（P〈0．05），拔管后5min，R组MAP和HR明显高于F组（P〈0．05）。呼吸恢复时间和拔管时间R组明显短于F组（P〈0．05），两组之间恶心呕吐发生率差异无显著性。结论神经外科手术中瑞芬太尼比芬太尼更能有效地抑制气管插管和手术导致的应激反应，且术后呼吸恢复快。

Anesthesia with remifentail and fentanil in neurosurgical operation

Objective The aim of this study was to evaluate the effects of remifentanil in comparison with those of fentanyl on the hemodynamic response,postoperative respiratory recovery time,extubation time and the incidence of postoperative nausea and vomiting during anasthesia induce and anasthesia maintenance in the elective neurosurgical opaeration.Methods 60 patients were randomly divided into 2 groups.Anesthesia was induced with remifentanil in group R or fentanyl in group F,and maintained with propofol remifen...