术毕维持输注瑞芬太尼对麻醉苏醒的影响(1)
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[摘要] 目的 麻醉苏醒过程中患者可能出现循环系统高动力反应。本文意在研究全麻苏醒期维持瑞芬太尼输注对于心血管反应、呛咳体动、苏醒快慢的影响。 方法 60例气管内插管全身麻醉下股骨颈骨折手术的患者，在麻醉苏醒时随机分为两组，对照组D组(n=30)及瑞芬太尼组R组(n=30)。手术结束时，D组停止用药，R组则维持静注瑞芬太尼0.05 μg/(kg·min)，直至拔除气管内导管。记录并评估两组患者的心率(HR)、平均动脉压(MAP)及苏醒期反应。结果 两组患者睁眼时间、拔管时间没有显著性差异，但是D组在苏醒时出现HR增快，MAP升高；R组HR升高不明显，MAP下降。在D组中出现恶心呛咳及体动例数比R组多。 结论 术毕维持瑞芬太尼输注可减少麻醉苏醒拔管时呛咳及体动，稳定血流动力学并且不延长苏醒时间。
[关键词] 瑞芬太尼；麻醉苏醒；血流动力学
[中图分类号] R614 [文献标识码] B [文章编号] 1673-9701(2012)02-0087-02
Effects of maintaining a remifentanil infusion on the recover time from anaesthesia at the end of surgery
HAN Bin ZHENG Mingwei
Anesthesia Department of the Red Cross Hospical of Shenyang City, Shenyang 110013, China
[Abstract] Objective To examine the effects of maintaining a remifentanil infusion on recovery profiles such as coughing and cardiovascular responses and the time of recovery after general anaesthesia. Methods Sixty patients undergoing fracture of neck of femur surgery under general anaesthesia usingtracheal intubation anaesthesia were randomly allocated to a control group(D group)(n=30) or remifentanil group (R group) (n=30) at the end of surgery, propofol was ceased and the infusion of remifentanil was stopped in D group and maintained in R group at concentration of 0.05 μg/(kg·min) until extubation. Heart rate (HR), mean arterial pressure (MAP), and recovery profiles were measured and evaluated. Results There was no significant difference in time to eye openingand time to extubation, but HR and MAP values were significantly higher in D group. Increases in HR were attenuated in the R group and MAP decreased during recovery compared withbaseline values. During emergence and tracheal extubation. Nausea or cough and body movement were more in D group than in R group (P<0.05). Conclusion Maintaining a remifentanil infusion reduced haemodynamic changes and coughing associated with tracheal extubation almost without significantly delaying recovery fromanaesthesia.
[Key words] Remifentanil; Recovery after anaesthesia; Hemodynamic
全身麻醉时，诱导期中的气管插管和苏醒期中的气管拔管对循环功能的影响较为显著，表现为血压升高、心率增快，甚至出现颅内压及腹内压升高、心肌缺血及心律失常等应激反应[1 ......
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