瑞芬太尼复合硝酸甘油控制性降压在鼻内镜手术中的应用

目的观察瑞芬太尼复合硝酸甘油行控制性降压在鼻内镜手术中的应用效果。方法选择60例鼻内镜手术患者，ASA分级I一Ⅱ级，采用数字表法随机分成三组：A组常规麻醉组，B组硝酸甘油组，C组瑞芬太尼复合硝酸甘油组，每组20例。观察各组在麻醉期间的血压、心率、术野质量、手术时间、拔管时间、术中出血量等指标的变化情况。结果手术持续时间：A组（103．8±27．4）min、B组（80．8±32．0）min、C组（81．2．4-20．2）min，三组差异有统计学意义（F=4．792，P〈0．05）；拔管时间：A组（25．9±7．5）min、B组（16．5±4．7）min、C组（10．4±4．4）min，三组差异有统计学意义（F=37．507，P〈0．01）；术中出血量：A组（209．2±50．3）mL、B组（150．8±45．9）mL、C组（133．8±34．9）mL，三组差异有统计学意义（F=16．011，P〈0．01）；术野质量评分：A组（3．61±0．56）分、B组（2．88±0．44）分、C组（1．91±0．32）分，三组术野质量评分差异有统计学意义（F=71．050，P〈0．01）。结论瑞芬太尼复合硝酸甘油控制性降压应用鼻内镜手术可达明显降压效果，改善术野质量，缩短手术时间以及缩短拔管时间。

Observation of controlled hypotension induced with remifentanil nitroglycerin in endoscopic sinus surgery

Objective To observe the effects of controlled hypotension induced with remifentanil nitroglycer- in in endoscopic sinus surgery. Methods 60 ASA I - Ⅱ patients treated with endoscopic sinus surgery were random- ly divided into 3 groups：general anesthesia（ group A）, nitroglycerin （group B）, remifentanil nitroglycerin group （group C）. The blood pressure, heart rate, the quality of the surgical field, surgical time, extubation time, blood loss and sur- geon satisfaction of the surgical field were observed during anesthesia. Results The operative time showed statistic significance between the groups （F = 4. 792, P 〈 0.05）.＇In terms of the extubation time, there was a statistically sig- nificant difference between the groups （ F = 37. 507, P 〈 0.01 ）. The blood loss and the quality of the surgical field were statistically significant between the groups respectively （ F = 16. 011, P 〈 0.01 ; F = 71. 050, P 〈 0.01 ）. Conclusion Controlled hypotension induced with remifentanil nitroglycerin in endoscopic sinus surgery can lower blood pressure effectively, improve the quality of surgical field, and shorten the operation time and the extubation time.