七氟烷联合瑞芬太尼对全身麻醉患者术中相关指标和术后苏醒质量的影响

发布时间：2018-03-07 21:42

本文选题：七氟烷　切入点：瑞芬太尼　出处：《中国药房》2015年33期 　论文类型：期刊论文

【摘要】：目的:探讨七氟烷联合瑞芬太尼对全身麻醉患者术中相关指标和术后苏醒质量的影响。方法:52例接受腹部择期手术患者随机均分为观察组和对照组。两组患者均给予依托咪酯0.3 mg/kg+阿曲库铵0.5 mg/kg+瑞芬太尼1μg/kg麻醉诱导后;观察组患者吸入七氟烷;对照组患者输注丙泊酚。记录两组患者麻醉诱导前(T0)、麻醉诱导后(T1)、气管插管时(T2)、切皮时(T3)、气腹后10 min(T4)、气腹结束前(T5)、拔管结束时(T6)的收缩压(SBP)、舒张压(DBP)、心率(HR)、脑电双频指数(BIS)及两组患者手术时间、麻醉时间、苏醒时间、拔管时间、简易精神状态量表(MMSE)评分及不良反应发生情况。结果:两组患者T6时SBP、HR,T4~6时DBP均显著高于同组T0时,T1~5时BIS均显著低于同组T0时,差异均有统计学意义(P0.05),但两组间比较差异无统计学意义(P0.05)。观察组患者苏醒时间、拔管时间均显著低于对照组,差异均有统计学意义(P0.05),两组患者手术时间、麻醉时间比较差异无统计学意义(P0.05)。两组患者拔管后0.5 h及拔管后1 h MMSE评分均显著低于同组术前,且对照组低于观察组,差异均有统计学意义(P0.05或P0.01);两组患者拔管后3 h MMSE评分均显著高于拔管后0.5 h及拔管后1h,差异均有统计学意义(P0.05),但两组间及与术前比较差异均无统计学意义(P0.05)。两组患者不良反应发生率比较,差异无统计学意义(P0.05)。结论:七氟烷或丙泊酚联合瑞芬太尼均能提供满意的麻醉效果,但七氟烷可控性更佳,安全性较好。
[Abstract]:Objective: to investigate the effect of sevoflurane combined with remifentanil on postoperative recovery quality and intraoperative indexes in patients with general anesthesia. Methods: 52 patients undergoing elective abdominal surgery were randomly divided into observation group and control group. Etomidate 0.3 mg/kg atracurium 0.5 mg/kg remifentanil 1 渭 g / kg anesthesia induction; Observation group patients inhaled sevoflurane; The patients in the control group were infused with propofol. The SBP, DBP, heart rate, HRP, T3, T5, T6) were recorded before anesthesia induction, after anesthesia induction, during tracheal intubation, during tracheal intubation, 10 min after pneumoperitoneum, 10 min after pneumoperitoneum, 10 min after pneumoperitoneum, and 10 min after pneumoperitoneum, and at the end of extubation, the systolic blood pressure (SBP), diastolic pressure (DBP), heart rate (HRT), brain electrical activity (EEG) were recorded. Bispectral index (BIS) and the operation time of the two groups, Results: the time of anesthesia, the time of recovery, the time of extubation, the score of mini-mental state scale (MMSE) and the occurrence of adverse reactions were all significantly higher in two groups than those in the same group at T0 and T1 ~ 5:00. Results: the DBP of SBPHRN T4 ~ 6:00 in T6 group was significantly lower than that in T0 group, and that in T0 group was significantly lower than that in T0 group. The difference was statistically significant (P 0.05), but there was no significant difference between the two groups. The recovery time and extubation time of the patients in the observation group were significantly lower than those in the control group, and the difference was statistically significant (P 0.05). The operation time of the two groups was significantly lower than that of the control group. There was no significant difference in anesthesia time between the two groups (P 0.05). The MMSE scores of the two groups were significantly lower than those of the same group at 0.5 h after extubation and 1 h after extubation, and the scores in the control group were lower than those in the observation group. The MMSE scores at 3 h after extubation in both groups were significantly higher than those at 0.5 h after extubation and 1 h after extubation (P 0.05), but there was no significant difference between the two groups and between the two groups before and after extubation (P 0.05). The incidence of adverse reactions was compared in the two groups. Conclusion: sevoflurane or propofol combined with remifentanil can provide satisfactory anesthetic effect, but sevoflurane is more controllable and safe.
【作者单位】：兴化市人民医院药剂科;连云港市第四人民医院药剂科;兴化市人民医院麻醉科;
【分类号】：R614.2

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