术中给予芬太尼对脊柱手术雷米芬太尼麻醉后患者苏醒质量的影响

发布时间：2019-05-29 17:12

【摘要】：目的探讨术中给予芬太尼对脊柱手术雷米芬太尼麻醉后患者苏醒质量的影响。方法 90例行脊柱手术患者按术中使用芬太尼剂量不同分为A组、B组及C组各30例,3组患者全麻诱导后,手术切皮前给予芬太尼3.0μg/kg静脉注射,A组患者术中不再追加使用,B组、C组患者术中分别间断使用芬太尼3.0μg/kg及6.0μg/kg静脉注射,并于手术结束前1 h完成最后一次注射。记录3组患者手术前(T0)、术后(T1)、意识恢复时刻(T2)、拔管时(T3)及拔管后10 min(T4)各时间点心率(HR)及平均动脉压(MAP)变化,同时记录患者苏醒期躁动程度(RS)、术后疼痛评分(VAS)及镇痛效果(Ramsay)评分。结果 3组患者MAP和HR在T0至T2变化差异无统计学意义(P0.05);3组患者MAP及HR在T3较T0时刻均明显升高,差异具有统计学意义(P0.05);A组患者MAP及HR在T4较T0时刻明显升高,且高于同期B组及C组,差异具有统计学意义(P0.05)。A、B两组患者自主恢复时间及意识恢复时间均明显短于C组,差异具有统计学意义(P0.05);A组与B组比较差异无统计学意义(P0.05)。B组及C组RS评分、VAS评分均明显低于A组,Ramsay评分均明显高于A组,B组Ramsay评分明显低于C组,差异具有统计学意义(P0.05)。结论使用雷米芬太尼麻醉的脊柱手术患者术中给予芬太尼3.0μg/kg静脉注射剂量可有效提高患者苏醒质量,预防患者雷米芬太尼麻醉后疼痛及痛觉过敏现象的发生。
[Abstract]:Objective to investigate the effect of fentfentanil on the recovery quality of patients undergoing spinal surgery after remifentanil anesthesia. Methods 90 patients undergoing spinal surgery were divided into group A (n = 30), group B (n = 30) and group C (n = 30). After induction of general anesthesia, fentanyl 3.0 渭 g / kg was given intravenously before operation. In group A, no additional use was given during operation. In group B and group C, fentanyl 3.0 渭 g / kg and 6.0 渭 g / kg were injected intravenously, and the last injection was completed one hour before the end of operation. The changes of heart rate (HR) and mean arterial pressure (MAP) were recorded before operation (T 0), postoperative (T 1), consciousness recovery time (T 2), extubation time (T 3) and 10 min (T 4) after extubation. At the same time, the postoperative pain score (VAS) and analgesic effect (Ramsay) score of restlessness after (RS), were recorded. Results there was no significant difference in MAP and HR between T0 and T2 in the three groups (P 0.05), but the MAP and HR in the three groups were significantly higher than those in the T0 group (P 0.05). MAP and HR in group A were significantly higher than those in group C at T 4, and were significantly higher than those in group B and group C at the same time (P 0.05). The time of spontaneous recovery and consciousness recovery in group A and B were significantly shorter than those in group C. The difference was statistically significant (P 0.05). There was no significant difference between group A and group B (P 0.05) RS score and VAS score in). B group and C group were significantly lower than those in group A, Ramsay score was significantly higher than that in group A, and Ramsay score in group B was significantly lower than that in group C. The difference was statistically significant (P 0.05). Conclusion intravenous injection of fentanyl 3.0 渭 g / kg during spinal surgery with remifentanil can effectively improve the awakening quality of patients and prevent the occurrence of pain and hyperalgesia after remifentanil anesthesia.
【作者单位】：荆州市第一人民医院麻醉科;
【分类号】：R614

【参考文献】