瑞芬太尼用于肝癌手术麻醉的临床观察

目的观察瑞芬太尼在肝癌手术中的应用效果。方法选择ASA（美国麻醉医师协会1分级Ⅰ～Ⅱ级择期在全身麻醉下行肝癌切除术患者30例，随机分为瑞芬太尼（R）组及异氟醚（I）组，R组采用瑞芬太尼和丙泊酚诱导及维持麻醉，Ⅰ组采用芬太尼和丙泊酚诱导，异氟醚维持麻醉。观察并比较两组患者麻醉诱导及维持期血流动力学的变化、术毕停药后患者自主呼吸恢复时间、清醒时间、拔管时间以及苏醒期不良反应等。结果Ⅰ组在手术牵拉过程中血压、心率升高明显，有统计学意义（P〈0．05），而R组各时间点血流动力学变化稳定（P〉0．05）。且R组自主呼吸恢复时间、睁眼时间、拔管时间与1组相比恢复快，清醒程度高，有显著性差异（P〈0．05）。结论瑞芬太尼麻醉术中循环波动较小、苏醒快、术后并发症少，可安全有效地用于肝癌切除术。

Clinical investigation of remifential anesthesia in hepatectomy for liver cancer

Objective To study the clinical effect of remifentanil anesthesia in hepatic cancer. Methods Thirty ASA Ⅰ - Ⅱ patients of liver cancer scheduled for elective hepatectomy were enrolled and randomly divided into two groups：group remifentanil （group R） and group isoflurane（group Ⅰ）.Group R were induced and maintained with remifentanil and propofol, while group Ⅰ with isoflurane and propofol.Hemadynamics changing during the induction and maintenance phase,spontaneous breath recovery time,awake time,time of endotracheal tube extubation and side-effect were investigated and compared. Results MAP during drag organs was significantly higher as compared with preoperative （P〈0.05） in group Ⅰ, while hemadynamics changing were no significantly differences in group R.But in group R,spontaneous breath recovery time,awake time,time of endotracheal tube extubation were shorter than group Ⅰ（P〈0.05）, and the score of OAAS（sedation scores after tracheal extubation） was higher than group Ⅰ. Conclusion Remifentanil anesthesia resulted in less circulatory disturbance,faster recovery and less postoperative complications,so remifentanil can be used more safely and effectively in hepatectomy for Liver Cancer.