缝皮前应用芬太尼对瑞芬太尼-丙泊酚麻醉恢复的影响(1)
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【摘要】 目的 探讨缝皮前应用芬太尼对瑞芬太尼-丙泊酚麻醉恢复的影响。方法 30例实施甲状腺腺瘤切除术患者随机均分成F1、F2和N组,缝皮前分别给予F1,F2组芬太尼1,2 μg/kg,N组为对照组,评定拔管后疼痛和镇静程度,记录呼吸恢复、意识恢复和拔管时间以及拔管后的不良事件,连续监测MAP和HR。结果 F1和 F2组的VAS评分较N组显著降低(P<0.01),两组Ramsay评分显著高于N组 (P<0.01),且 F2较F1显著增高 (P<0.05)。F2组的呼吸恢复、意识恢复和拔管时间与F1和N组相比均明显延长(P<0.01)。N组的MAP和HR在恢复过程中逐渐升高,而F1和 F2组的MAP和HR变化相对较平稳。结论 在甲状腺腺瘤切除术缝皮前应用1μg/kg芬太尼可减轻瑞芬太尼停药后的疼痛反应,但不显著延迟苏醒和拔管时间。
【关键词】 芬太尼;瑞芬太尼;丙泊酚;术后疼痛
Effect of fentanyl application on remifentanyl-propofol anesthesia recovery before skinning suture
YAN Li,WANG Jian-hua.
Anaesthesia Department of Xuzhou center hospital Jiangsu,221000,China
【Abstract】 Objective To discuss the effect of fentanyl application on fentanyl-propofol anesthesia recovery before skinning suture.Methods Thirty cases of thyroid gland adenoma excision were divided into F1,F2 and N groups,1 or 2 μg/kg fentanyl were given before skinning suture in F1or F2 group,N group as control group.The degree of pain and sedation were assessed,recovery time of breathing,consciousness recovery,extubation time and the adverse events were recorded,MAP and HR were continuing monitored.Results Compared with N group,score of VAS grade in F1 and F2 groups were significantly reduced (P<0.01); Score of Ratings Ramsay in F1 and F2 group were higher than in N group (P<0.01),and increased more significantly in F2 group (P<0.05).Compared with F1 and N group,recovery time of breathing,consciousness recovery and extubated time were extended in F2 group(P<0.01).During recovery,MAP and HR were gradually increased in N group,and remained relatively stable in F1 and F2 groups.Conclusion Before skinning suture of thyroid gland adenoma excision,application of 1μg/kg fentanyl could reduce pain response of remifentanyl discontinuation,but not significantly delay recovery of consciousness and extubated time.
【Key words】Fentanyl; Remifentanil; Propofol; Postoperative pain
临床上以瑞芬太尼为基础的麻醉术毕镇痛不足的问题较为常见,本研究探讨进行甲状腺腺瘤切除术时芬太尼用于瑞芬太尼和丙泊酚全凭静脉麻醉后镇痛的适宜剂量和方法,为临床合理应用提供参考。
1 资料与方法
1.1 一般资料 选择30例行甲状腺腺瘤切除术的患者,ASAⅠ或Ⅱ级,性别不限,年龄20~55岁,体质量50~75 kg ......
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