胃癌根治术中瑞芬太尼复合丙泊酚的麻醉效果观察

发布时间：2018-11-27 08:43

【摘要】：目的探讨瑞芬太尼复合丙泊酚在临床胃癌根治术中的应用效果与安全性。方法选取42例行胃癌根治术的患者,随机分为瑞芬太尼组(A组)及芬太尼组(B组)各21例。两组常规麻醉诱导后,A组应用瑞芬太尼0.3μg/(kg·min);B组应用芬太尼0.4μg/(kg·min)维持麻醉,两组均以丙泊酚100μg/(kg·min)持续静脉输注。对比两组患者麻醉诱导前后、气管插管及术中的血压、心率变化、拔除气管导管时间、睁眼时间、术后恶心呕吐及术后疼痛情况。结果两组患者T_1较T_0时收缩压(SP)、舒张压(DP)、心率(HR)均明显下降(P0.05),两组的心率除气管插管前A组低于B组外,其他差异无显著性。T_2与T_1期比较,B组患者SP、DP、HR均明显上升(P0.05),而A组患者差异无显著性(P0.05)。两组患者麻醉时间差异无显著性(P0.05),拔除气管导管时间、术后睁眼时间及正确回答问题时间A组明显短于B组(P0.05)。两组患者术后复苏均安静且均无术中知晓,B组拔管后有6例发生呼吸抑制,对症处理后缓解,而A组无呼吸抑制;A组术后10~15分钟出现伤口疼痛,B组无伤口疼痛情况,两组均出现术后呕吐,差异无显著性(P0.05)。结论在胃癌根治术麻醉中,瑞芬太尼复合丙泊酚临床麻醉效果优于芬太尼复合丙泊酚,且呼吸抑制轻苏醒时间短。
[Abstract]:Objective to evaluate the efficacy and safety of remifentanil combined with propofol in the radical resection of gastric cancer. Methods 42 patients undergoing radical gastrectomy were randomly divided into remifentanil group (group A) and fentanyl group (group B). After routine anesthesia induction, remifentanil 0.3 渭 g / (kg min); B group was administered with fentanyl 0.4 渭 g / (kg min) for maintenance anesthesia and propofol 100 渭 g / (kg min) was given continuously intravenously in both groups. Before and after anesthesia induction, the changes of blood pressure, heart rate, extubation time, eye opening time, postoperative nausea and vomiting and postoperative pain were compared between the two groups. Results the systolic pressure (SP), diastolic blood pressure (DP), heart rate (HR) of the two groups were significantly lower than that of the control group (P0.05). The heart rate of both groups was lower than that of group B before tracheal intubation. The SP,DP,HR of group B was significantly higher than that of group A (P0.05), but there was no significant difference in group A (P0.05). There was no significant difference in anesthesia time between the two groups (P0.05). The time of removing trachea catheter opening eyes and answering questions correctly in group A was significantly shorter than that in group B (P0.05). The postoperative resuscitation in both groups was quiet and no intraoperative knowledge. There were 6 cases of respiratory inhibition after extubation in group B, remission after symptomatic treatment, but no respiratory inhibition in group A. There was no pain in group A and no pain in group B. there was no significant difference in postoperative vomiting between group A and group B (P0.05). Conclusion remifentanil combined with propofol is more effective than fentanyl combined with propofol in radical anesthesia of gastric cancer, and the time of mild recovery from respiratory inhibition is shorter than that of remifentanil combined with propofol.
【作者单位】：山东省医学科学院附属医院麻醉科;
【分类号】：R614;R735.2

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