瑞芬太尼全凭静脉麻醉在支撑喉镜手术的应用(1)
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2010年11月5日
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[摘要] 目的：观察瑞芬太尼联合异丙酚全凭静脉麻醉在支撑喉镜声带息肉切除术中的麻醉效果。方法：择期行支撑喉镜声带息肉切除术的患者40例，ASAⅠ或Ⅱ级，术前检查均无重要脏器疾病史及药物过敏史。将40例患者随机分为2组，每组各20例：异丙酚-芬太尼全麻组为对照组(F组)，异丙酚-瑞芬太尼全麻组为观察组(R组)。记录两组患者的心血管反应、苏醒拔管时间及苏醒质量。结果：①R组患者血流动力学变化比F组平稳(P<0.05)；②R组患者苏醒拔管时间明显短于F组(P<0.05)，拔管即刻及离开手术室送PACU时OAA/S评分R组明显高于F组(P<0.05)。结论：瑞芬太尼联合异丙酚全凭静脉麻醉在支撑喉镜声带息肉切除术，具有心血管反应轻、苏醒快等优点，是一种较理想的麻醉方法。
[关键词] 瑞芬太尼；支撑喉镜；声带息肉切除术
[中图分类号] R739.65[文献标识码] B [文章编号] 1674-4721(2010)11(a)-069-02
Clinical use of reminfentanil total intravenous anesthesia in patients undergoing suspensive laryngoscope
TANG Huadong, LIN Yushuang, ZHANG Wenqing, XU Sanrong
(Department of Anesthesiology, Zhangzhou Affiliated Hospital, Fujian Medical University, Zhangzhou 363000, China)
[Abstract] Objective: To evalute propofol with remifentanil during operation of suspension laryngoscopy. Methods: The elective laryngoscope polyp resection 40 patients, ASA Ⅰ or class Ⅱ, no vital organs preoperative medical history and drug allergies. The 40 patients were randomly divided into two groups, 20 patients in each group: propofol-fentanyl anesthesia group as a control group (F group), propofol-remifentanil anesthesia group in the observation group (R group). Cardiovascular response to the two groups of patients, recovery time and wake up the quality of extubation. Results: ①R hemodynamic changes in patients stable than the F group (P<0.05); ②R group were awake extubation time was significantly shorter than F group (P<0.05), tracheal extubation, and PACU time to leave the operating room to send OAA/S Rated R was significantly higher than F group (P<0.05).Conclusion: Remifentanil and propofol total intravenous anesthesia in the excision of vocal polyps laryngoscope, with the cardiovascular response to light, rapid recovery, etc., is an ideal method of anesthesia.
[Key words] Remifentanil; Laryngoscope; Vocal cord polypectomy
支撑喉镜手术时间短但是刺激强容易引起强烈的心血管反应，患者全麻后恢复需要一定的时间，因此要求麻醉深度合适，可控性强，诱导快，苏醒迅速安全。瑞芬太尼是超短效μ阿片受体激动剂，其作用时间短，麻醉后苏醒迅速，被广泛应用于临床。本研究旨在评价瑞芬太尼联合异丙酚静脉麻醉和枸橼酸芬太尼联合异丙酚静脉麻醉用于支撑喉镜手术的临床麻醉效果，观察比较心血管反应、苏醒拔管时间及苏醒质量。瑞芬太尼药效强于或(和)芬太尼相似[1] ......
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