瑞芬太尼和丙泊酚静脉麻醉与异氟醚吸入麻醉在老年人腹腔镜胆囊切除术中的应用比较被引量：1

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摘要目的比较瑞芬太尼复合丙泊酚吸入用于老年人LC手术的麻醉效果。方法选择60例拟行LC手术的老年病人，ASAⅠ—Ⅱ级，随机分为瑞芬太尼复合丙泊酚组（R组，n=30）和异氟醚组（Ⅰ组，n=30）。两组麻醉诱导相同，咪唑安定0.1mg·kg^-1，丙泊酚15mg·kg^-1，芬太尼3—4ug·kg^-1·h^-1。Ⅰ组持续吸入异氟醚3％-4％。两组术中持续静注阿曲库铵控制肌松和呼吸，观察两组围手术期血流动力学变化、术后恢复情况及不良反应。结果R组术中血流动力学指标较Ⅰ组平稳，术后呼之睁眼及拔管是时间短于Ⅰ组（P〈0.01），苏醒期烦躁、高血压、恶心呕吐发生率明显低于Ⅰ组（P〈0．01）。结论瑞芬太尼复合丙泊酚静脉麻醉与异氟醚吸入麻醉比较，具有血流动力学稳定，术后苏醒快，不良反应少，安全可行的优点。适用于老年患者LC手术。

作者方华田先平

机构地区浙江省杭州余杭第三人民医院

出处《当代医学》 2008年第7期147-148,共2页 Contemporary Medicine

关键词瑞芬太尼丙泊酚异氟醚老年人腹腔镜胆囊切除术

分类号 R614 [医药卫生—麻醉学]

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参考文献1

1余淑珍,刘保江.瑞芬太尼的药理学、临床研究和应用进展[J].国外医学（麻醉学与复苏分册）,2004,25(6):356-358. 被引量：120

二级参考文献19

1David S. Hemodynamics and emergence profie of remmifentanil versus fentanyl prospectively compared in a large population of surgical patients. Survey of Anesthesiology,2002,46(4): 207-208.
2Enrique C, Antonio P, Pedro A, et al. A comparison of two constant-dose continuous infusion of remifentanil for severe postoperative pain. Anesthesia & Analgesia, 2001,92(3) :715-719.
3Stefan S, Matthew C, Gavin K. Lack of rapid development of opioid tolerance during alfentanil and remifentanil infusion for postoperative pain. Anesthesia & Analgesia, 1999,89(3): 753.
4Penny KJ, Randall S, James S. The use of remifentanil infusion to allow intraoperative awakening for intentional fracturing of the anterior cervical spine. Anesthesia & Analgesia, 1999,89(4): 1059-1062.
5Danelli G,Berti M, Casati A, et al. Spinal block or total intravenous anaesthesia with propfol and remifentanil for synaecological outpatient procedures. European Journal of Anaesthesiology,2002, 19(8) :594-599.
6Jones R, Pegrum A, Stacey RG. Patient-controlled analgesia using remifentanil in the parturient with thrombocytopaenia. Anaesthesia, 1999,54(5):461-465.
7Victor C, Gilles G, Gilles G, et al. Target-Controlled Infusion for Remifentanil in Vascular Patients Improves Hemodynamics and Decreases Remifentanil Requirement. Anesthesia & Analgesia, 2003,96( 1 ): 33-38.
8Servin F, Desmonts JM, Watkins WD. Remifentanil as an analgesic adjunct in local/regional anesthesia and in monitored anesthesia care. Anesth Analy, 1999,89(4) :28-32.
9Myre K, Raeder J, Rostrup M, et al. Catecholamine release during laparoscopic fundoplication with high and doses of remifentanil. Acta Anaestheiol Scand,2003,47(3): 267-273.
10Barvais L, Engelman E, Eba JM, et al. Effect site concentration of remifentanil and pupofol to noxious stimulation. British Journal of Anaesthesia,2003,91 (3) :347-352.