瑞芬太尼全麻在经皮肾镜碎石手术麻醉中的应用价值

［摘要］目的　探讨瑞芬太尼全麻在经皮肾镜碎石术（PCNL）中的麻醉效果及应用价值．方法　选取2012年7月至2014年8月昆明市延安医院收治的60例择期行PCNL的住院患者，随机分成2组，每组30例，2组均行常规麻醉准备与咪达唑仑注射液、丙泊酚、维库溴铵、芬太尼麻醉诱导行气管插管全麻，对照组术中给予芬太尼+丙泊酚维持麻醉，观察组术中给予瑞芬太尼+丙泊酚维持麻醉，观察2组麻醉效果．结果　2组患者在手术时间、术后清醒时间、麻醉药物用量、出血量方面无统计学意义（P＞0.05）；对照组T3点收缩压和舒张压较T0点相比均有所升高，与观察组相比有统计学意义（P＜0.05），2组麻醉期间均无不良反应发生．结论　使用瑞芬太尼行经皮肾镜碎石术全麻效果比较稳定，值得推广使用．

Clinical Value of General Anesthesia with Remifentanil for Percutaneous Nephroscope Lithotripsy

［Abstract］Objective To study the anesthesia effects and application value of remifentanil anesthesia in percutaneous nephroscope lithotripsy. Methods　We selected 60 undergoing elective PCNL hospitalized patients during July 2012 - August 2014 of the hospital. Then divided the patients randomly into two groups，30 cases in each group，control group and observation group，both of the groups were applied general anesthesia in preparation and midazolam，propofol，vecuronium bromide and fentanyl injection anesthetic induction to apply endotracheal intubation anesthesia. During the Surgery，we applied fentanyl & propofol on the control group to maintain anesthesia and given remifentanil & propofol to the observation group. Then we observed the narcotic effect of two groups. Results　The operation time，postoperative awake time， the dosage of anesthetic drugs， blood loss between the two groups of patients had no significant difference（P > 0.05）；cmpared with the observation group（P < 0.05），control group's T3 points and T0 points increased. And the same time， two groups had no adverse reactions occurred during anesthesia. Conclusion The effect of general anesthesia using remifentanil in percutaneous nephroscope lithotripsy is positive， and is worthy of promotion.