异丙酚复合芬太尼或瑞芬太尼靶控静脉麻醉与静吸复合麻醉的效果对比

摘要

目的 比较分析异丙酚复合芬太尼或瑞芬太尼靶控静脉麻醉与静吸复合麻醉的临床效果.方法 选取2010年6月至2012年2月我院96例ASA Ⅰ～Ⅱ级择期手术患者,随机分为异丙酚复合芬太尼靶控组(A组)、异丙酚复合瑞芬太尼靶控组(B组)和静吸复合麻醉组(C组)各32例,观察并记录患者麻醉诱导及维持过程中血压、心率的变化；记录术毕停药后患者自主呼吸恢复时间、清醒时间、拔管时间、定向力恢复时间；术后24 h访视患者,观察有无恶心、呕吐等不良反应.结果 三组患者SBP、DBP、MAP、HR诱导时最低值无显著差异(P＞0.05).诱导时A、B组SBP＜ 90 mmHg者显著少于C组(P＜0.05).A、C组插管反应发生率显著高于B组(P＜0.05).三组患者术毕自主呼吸恢复时间、清醒时间、拔管时间及定向力恢复时间无显著差异(P＞0.05),A、B组不良反应发生率显著低于C组(P＜0.05).结论 与静吸复合麻醉比较,异丙酚复合芬太尼或瑞芬太尼靶控静脉麻醉诱导更加平稳,不良反应少,值得推广应用.%Objective To compare the clinical effects of target controlled intravenous anesthesia of propofol combined with fentanyl or remifentanil and isoflurane.Methods 96 ASA Ⅰ-Ⅱ elective surgical patients from June 2010 to February 2012 were randomly divided into three groups of 32 patients:propofol combined with fentanyl target-controlled group (group A),compound propofol remifentanil fentanyl target-controlled group (group B),anesthesia group (group C).Blood pressure,heart rate changes in anesthesia induction and maintenance were observed and recorded; spontaneous breathing recovery time,wake time,time to extubation,orientation recovery time were recorded; during 24 hours follow-up,nausea,vomiting and other adverse events were observed.Results The SBP,DBP,and the MAP,the H R induced by the lowest value in three groups had no significant difference (P＞0.05).Patients of the SBP ＜90 mmHg in Group A and Group B were significantly less than those of group C (P＜0.05).Intubation in Group A and group C were significantly higher than those in group B (P＜0.05).Recovery time of spontaneous breathing,wake time,time to extubation and orientation recovery time in three groups had no significant difference (P＞0.05).Incidence of adverse reactions in group A and group B was significantly lower than that of group C (P＜0.05).Conclusion Compared with isoflurane inhalation anesthesia,propofol combined with fentanyl or remifentanil target controlled intravenous anesthesia is more stable with less adverse reaction.