瑞芬太尼控制性降压在鼻内镜手术中的应用

目的研究硝普纳（SNP）复合瑞芬太尼在鼻内镜手术中行控制性降压麻醉的有效性和安全性。方法60例需行鼻内镜手术者，随机分为A、B组，每组30例。A组用局麻加强化；B组用微量泵注瑞芬太尼和异丙酚，当需要鼻内镜控制性降压麻醉时，B组泵注SNP复合瑞芬太尼将MABP降至并维持于60—70mmHg。观察术前、术中，术后10分钟时的血流动力学变化。结果B组的降压效果满意，且HR相对稳定。血压下降速度B组明显快于A组。B组血流动力学变化幅度优于A组（P〈0．05）。结论瑞芬太尼复合SNP能强化SNP的降压效果，减少出血量，缩短手术时间，维持降压中血流动力学的稳定。

The application of controlled hypotension with remifentanil in nasal endoscopic surgery

Objective To study the efficacy and safety of sodium nitroprusside(SNP) with remifentanil used for controlled hypotension in nasal endoscopic surgery.Methods Sixty children undergoing operation were randomly divided into A and B group.Local anesthesia was in A group;Anesthesia was maintained with the continuous infusion of remifentanil and propofol in B group.Controlled hypotension was performed and the MAP was reduced and maintained between 60~70 mmHg with the continuous infusion of SNP.Hemodynamic changes before operation,in operation and 10 min after operation were observed.Results Data in B groups showed high satisfaction with hypotension,HR was stability in B group.Hemodynamic changes were better in B group than in A group(P<0.05).Conclusions Remifentanil could potentiate the hypotensive effect of SNP,decrease the bleeding amount,shorten the operation time and maintain a stable hemodynamics during controlled hypotension.