瑞芬太尼复合丙泊酚靶控输注对脑肿瘤围术期指标的影响

目的:探讨瑞芬太尼复合丙泊酚靶控输注对脑肿瘤围手术的影响，为脑肿瘤患者实施最佳麻醉方法。方法:选取脑肿瘤患者134例，随机分为两组。对照组患者采取丙泊酚、瑞芬太尼、维库溴铵诱导麻醉后，静脉复合吸入异氟醚维持麻醉；观察组患者实施瑞芬太尼复合丙泊酚靶控注射麻醉。结果:麻醉诱导期观察组患者SBP、DBP最低分别为（101.59±10.26）mmHg和（54.43±5.27）mmHg，对照组分别为（91.65±9.22）mmHg和（47.36±4.52）mmHg，观察组明显高于对照组。术后观察组患者定向力恢复时间为（16.32±2.01）min，对照组为（22.76±2.83）min，观察组明显短于对照组。观察组患者拔管后即刻、离开手术室时以及拔管后1h OAAS得分分别为3.19±0.30、4.12±0.23和4.52±0.42，对照组分别为2.23±0.18、3.28±0.31和4.01±0.36，观察组患者拔管后1h MMSE得分为28.15±1.02，对照组为26.92±1.73，观察组明显高于对照组，上述比较两组差异有统计学意义（P<0.05）。结论:瑞芬太尼复合丙泊酚靶控输注与静吸复合麻醉相比诱导期生命体征更为平稳，术后苏醒质量更高，因此也更适合脑肿瘤手术患者麻醉。

Perioperative influence on paitents with remifentanil and propofol by target - controlled infusion

Objective:To investigate perioperative influence on paitents with remifentanil and propofol by target-controlled infusion.Methods:All 134 brain tumor patients were selected，were randomly divided into two groups.Control group were anaesthetized with propofol，remifentaniland vecuronium，and intravenous anesthesia was maintained with isoflurane，intravenous anesthesia was maintained with isoflurane,observation group were anaesthetized with remifentanil and propofol by target-controlled injection of anesthesia.Results:The induction of anesthesia in patients in the observation group SBP，DBP were lowest respectively (101.59±10.26)mmHg and (54.43±5.27)mmHg，respectively，in the control group were (91.65±9.22)mmHg and (47.36±4.52)mmHg，the observation group was significantly higher in the control group.Disorientation postoperative recovery time in the observation group was (16.32±2.01)min，the control group (22.76±2.83)min，the observation group was significantly shorter than the control group,the observation group were extubated immediately after leaving the operating room when and 1hOAAS score after extubation were 3.19±0.30，4.12±0.23 and 4.52±0.42，respectively，in the control group 2.23±0.18，3.28±0.31 and 4.01±0.36，was observed patients after extubation 1h MMSE score 28.15±1.02，the control group 26.92±1.73，the observation group was significantly higher (P<0.05).Conclusion:The remifentanil target-controlled infusion of propofol and inhalation anesthesia induction period compared to a more stable vital signs，postoperative recovery with higher quality，and therefore more suitable for brain tumor surgery anesthesia.