摘要
目的：探讨脊柱侧弯矫形术中丙泊酚复合舒芬太尼或瑞芬太尼静脉全麻对患者术中唤醒质量的影响。方法选择行脊柱侧弯矫形手术患者50例,随机均分为两组,术中持续静脉泵注丙泊酚复合舒芬太尼0.3-0.6μg·kg-1·h-1（SF 组）或瑞芬太尼0.2-0.3μg·kg-1·min-1（RF 组）维持麻醉,术中 BIS 维持在40-60。进行唤醒时,SF 组停止泵入舒芬太尼；RF 组调整瑞芬太尼泵速为0.05μg·kg-1·min-1,直到患者配合指令完成唤醒试验。记录患者的恢复时间（包括出现自主呼吸、体动、能够配合指令的时间）；观察患者唤醒有无躁动；记录两组分别调整用药后10 min（T1）、唤醒时（T2）、唤醒后10 min（T3）的 MAP、HR、PET CO2。结果 RF 组患者的恢复时间明显短于 SF 组（P 〈0.05）；患者配合指令动脚期间,RF 组的躁动率明显高于 SF 组（P 〈0.05）；T2时 RF 组 HR 明显快于 SF 组（P 〈0.05）。结论丙泊酚复合舒芬太尼用于脊柱侧弯矫形术中唤醒质量高,血流动力学更稳定,但唤醒时间相对延长。
Objective To compare the influence of propofol combined with sufentanil or remifentanil on the quality of wake-up during scoliosis surgery by wake-up test.Methods Fifty pa-tients undergoing scoliosis surgery were randomized into two groups.During the surgery,propofol combined with sufentanily 0.3-0.6 μg·kg-1·h-1 （group SF）or remifentanil 0.2-0.3 μg·kg-1·min-1 （group RF）were continuously infused to maintain anesthesia,and BIS was maintained at 40-60.In wake-up test,the infusion of sufentanyl in group SF was paused and,the infusion rate of remifentanil in group RF was adjusted to 0.05 μg·kg-1·min-1 until the patient completed the wake-up test under instruction.The time that spontaneous breathing occurred,body movement was detected and the capa-bility to follow instructions in both two groups were recorded.MAP,HR,PET CO2 were measured at the time 10 min after medication adjustment （T1 ）,waking up（T2 ）and 10 min after waking up （T3 ）, respectively,in both two groups.Wake-up quality was also recorded.Results The time that sponta-neous breathing occurred,body movement was detected and the capability to follow instructions in group RF were significantly shorter than those in group SF （P 〈0.05）.At T2 the incidence of agita-tion in group RF was significantly higher than that in group SF（P 〈0.05）.And the hemodynamics of group SF were more stable than those of group RF （P 〈0.05）.Conclusion Propofol combined with sufentanil can improve wake-up quality during scoliosis surgery,but the wake-up time is relatively lon-ger.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2014年第7期648-650,共3页
Journal of Clinical Anesthesiology
