靶控输注异丙酚和瑞芬太尼静脉麻醉在隆乳手术中的应用

目的：观察异丙酚复合瑞芬太尼靶控静脉全麻（Target controlled infusion,TCI）用于门诊隆乳手术的麻醉效果。方法：ASAⅠ～Ⅱ级门诊隆乳手术患者60例,随机分为异丙酚复合瑞芬太尼靶控输注组（RP组,n=30）和氯胺酮恒速输注组（K组,n=30）。观察两组患者的术后初醒时间,准确定向时间、离院时间;术中体动程度和次数、术者评价的麻醉效果、呼吸抑制评分和HR、MAP、SpO2及术后并发症的发生情况。结果：两组患者初醒时间、准确定向时间、离院时间有明显差异,RP组明显小于K组（P〈0.05）。麻醉效果评分RP组好于P组（P〈0.05）,且其体动程度评分和次数均低于K组（P〈0.05）,两组间呼吸抑制评分无明显差异（P〉0.05）。RP组术中HR、MAP的变化较K组平稳,差异有显著性（P〈0.05）。RP组恶心、呕吐及不良记忆等术后并发症的发生也明显少于K组（P〈0.05）。结论：异丙芬复合瑞芬太尼芬TCI输注用于隆乳手术,镇静、镇痛效果好,循环更稳定,术后恢复快,不良反应少,是门诊隆乳手术理想的麻醉方法。

Application of Target controlled infusion propofol and Remifentanil intravenous anesthesia in augmentation mammoplasty

Objective To observe the effect of target controlled infusion （TCI） propofol and Remifentanil intravenous anesthesia in augmentation mammoplasty. Methods Sixty ASA grade I ～II out -patients undergoing augmentation mammoplasty,were randomly separated into remifentanil and propoful target controlled infusion group （RP group,n=30） and ketamine constant infusion group （K group,n =30）. The recovery time,orientation time,discharge time,body movement during operation,anesthestic satisfactory,respiratory depression score,and HR,MAP,SpO2 were also recorded. Results The recovery time,orientation time,and discharge time of RP group were significantly shorter than K group （P〈0.05）. The extent and frequency of body movement were reduced significantly in PR group than in K group,and the anesthesia score was also higher in PR group （P〈0.05）. Respiratory depression score between the two groups was no significant difference （P〉0.05）. The changes of HR and MAP in RP group during the operation were more stable than K group（P〈0.05）. The occurrence of nausea,vomiting and bad recall after operation in RP group was also reduced （P〈0.05）. Conclusion Target controlled infusion （TCI） propofol and Remifentanil intravenous anesthesia is an ideal method in augmentation mammoplasty,which has a good effect of anesthesia and analgesia,then the side effect and the influence on the circulative function are mild,and the patients can recovery rapidly after operation.