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1、瑞芬太尼芬太尼及瑞芬太尼復(fù)合全麻對照探究作者：周清河肖旺頻姚明安爾丹杜炎芳【摘要】目的對比研究瑞芬太尼、芬太尼復(fù)合瑞芬太尼在全麻術(shù)中應(yīng)用的可行性和有效性。方法ASAI?II級腹部胃腸道手術(shù)患者60例隨機分為三組：F、R組和RF組，每組20例。F組血漿靶控芬太尼術(shù)中鎮(zhèn)痛，芬太尼血漿靶濃度根據(jù)手術(shù)刺激調(diào)整，手術(shù)結(jié)束前半小時停止；R組用瑞芬太尼替代芬太尼；RF組瑞芬太尼復(fù)合芬太尼，胃腸道吻合操作気成前主要由芬太尼維持鎮(zhèn)痛，其后主要由瑞芬太尼維持鎮(zhèn)痛。結(jié)果R組誘導(dǎo)時發(fā)生嗆咳、肌肉強直、心動過緩均比其余兩組多。R組蘇醒期MAP和HR與其余兩組相比明顯增高(P<；0.05)o蘇醒期R組發(fā)生躁動、高
2、血壓、心動過速均比其余兩組增多明顯。與F組相比，R和RF組拔管時間、出恢復(fù)室時間明顯縮短(P<；0.05)oRF組瑞芬太尼用量與R組相比明顯減少(P<；0.05),RF組芬太尼用量與F組相比明顯減少(P<；0.05)oR、RF組的拔管后即刻、離開PACU、拔管后lhOAA/S評分明顯比F組高(P<；0?05)。RF組患者拔管后即刻、離開PACU時疼痛評分與R組相比，差異顯著(P<；0.05)o結(jié)論三種麻醉方法術(shù)中均能提供良好的鎮(zhèn)痛，滿足手術(shù)要求。但瑞芬太尼聯(lián)合芬太尼既能提供完善的鎮(zhèn)痛，維持術(shù)中血流動力學(xué)平穩(wěn)，術(shù)畢又能蘇醒迅速且蘇醒質(zhì)量高?！娟P(guān)鍵詞】芬太尼瑞芬太尼全身麻醉
3、靶控輸注[Abstract】ObjectiveTomakeacomparativestudyonthefeasibilityandvalidityofusingremifentanilsfentanylandremifentanilingeneralanaesthesia?Methods60ASAclassI?Ilpatientsundergoingabdomenoperationswererandomlydividedintothreegroups：groupF、groupRandgroupRFwith20casesineachgroup.IngroupF,analgesiawasind
4、ucedandmaintainedwithTCIfentanyl.Thetargetplasmaconcentrationoffentanylwasadjustedbasedonoperationstimulationandstoppetat30minbeforetheendofsurgery.InGroupR,fentanylwasreplacedbyremifentanil.InGroupRF,analgesiawasinducedandmaintainedwithTCIremifentanil-fentanyl,analgesiawasmaintainedwithfentanylbe
5、foregastrointestinaltractanastomosisandwithremifentanilafterwards?ResuItsTheoccurrenceofcough、muscletwitch、bradycardiaingroupRweremorethanothertwogroupsduringinducement.MAPandHRingroupRweresignificantlyhigherthanothertwogroupsduringrecoveryfromanesthesia(P<；0.05)?Theoccurrenceoffidget、hypertensi
6、on、tachycardiaweremorethanothertwogroupsduringrecoveryfromanesthesia(P&It；0.05).ThedurationfromterminationofanesthesiatotracheaextubationandthestayinPACUwassignificantlyshorteringroupRandgroupRFthaningroupF(P&It；0.05)?ThequantityofremifentanilusedingroupRFwassignificantlylowerthaningroupRandthequa
7、ntityoffentanylusedingroupRFwassignificantlylowerthaningroupF(P&It；0.05)?TheOAA/SscoresweresignificantlygreateringroupRandgroupRFthaningroupFatthetimepointoftracheaextubation、leavingPACUandlhaftertracheaextubatio
