[摘要] 目的 观察瑞芬太尼在甲状腺手术中的应用效果。 方法 选择ASA(美国麻醉医师协会) 分级Ⅰ-Ⅱ级择期在颈丛复合全身麻醉下行甲状腺次全切除术病人40例，随机分为瑞芬太尼(R)组及芬太尼(F)组，R组采用瑞芬太尼和丙泊酚诱导和维持麻醉，F组采用芬太尼和丙泊酚诱导和维持麻醉，观察并比较两组病人麻醉诱导及维持期血流动力学的变化、术中丙泊酚和阿曲库铵的用量、术毕停药后病人自主呼吸恢复时间、清醒时间、拔管时间以及苏醒期不良反应等。 结果 瑞芬太尼麻醉术中循环波动较小，苏醒快，术后并发症少。 结论 与芬太尼相比，瑞芬太尼可更安全有效地用于甲状腺次全切除术。

    [关键词] 瑞芬太尼；颈丛阻滞；全身麻醉；甲状腺次全切除术

    Clinical observation on remifentanil anesthesia in thyroidectomy YANG Ke, ZHONG Taidi. Department of Anesthesia, Sir Run Run Shaw Hospital, Zhejiang University Medical College, Hangzhou 310016, China

    [Abstract] Objective To study the clinical effect of remifentanil anesthesia in thyroidectomy. Methods Forty ASAⅠ-Ⅱpatients scheduled for elective thyroidectomy under cervical plexus block combined with general anesthesia were enrolled and randomly divided into two groups: group remifentanil (R) and group fentanyl (F). Group R were induced and maintained with remifentanil and propofol, while group F with fentanyl and propofol. Hemadynamics changing during the induction and maintenance phase, doses of propofol and atracurium, spontaneous breath recovery time, awake time, time of endotracheal tube extubation and side-effect were investigated and compared. Results There were no significant differences in doses of propofol and atracurium between two groups. Remifentanil anesthesia resulted in less circulatory disturbance, faster recovery and less post-operative complications. Conclusion Compared with fentanyl, remifentanil can be used more safely and effectively in thyroidectomy. ......