静脉麻醉和静吸复合麻醉用于脊柱手术患者的唤醒比较

龙健晶; 张宏

静脉麻醉和静吸复合麻醉用于脊柱手术患者的唤醒比较

龙健晶,
张宏

Intraoperative wake-up test in patients undergoing spinal surgery:A comparison of intravenous anesthesia and combined intravenous and inhalation anesthesia

摘要

摘要: 目的:对脊柱手术中应用静脉麻醉和静吸复合麻醉进行快速唤醒比较,为临床提供有益的参考。方法:45例患者随机平均分为3组:1)PR组（异丙酚-瑞芬太尼）:异丙酚靶控输注（血浆浓度2～4μg·mL^-1）和瑞芬太尼0.2～0.4μg·kg^-1·min^-1;2)DR组（地氟醚-瑞芬太尼）:地氟醚-空气3.0Vol%~4.0Vol%,合用瑞芬太尼0.2～0.4μg·kg^-1·min^-1;3)PFN组（异丙酚-芬太尼-氧化亚氮）:异丙酚靶控输注（血浆浓度2～4μg·mL^-1）,复合吸入氧化亚氮（N₂O∶O₂=1∶1）,根据需要间断注射芬太尼1～2μg.kg-1。结果:PFN组出现自主呼吸（8.9±1.6）min和活动双足（12.3±5.6）min所需时间明显长于PR组分别为（6.7±2.1）min和（9.8±2.4）min和DR组分别为（5.8±0.6）min和（6.4±0.9）min。结论:与PR组及PFN组相比,DR组的麻醉方案使患者在术中苏醒更快,可以立即进行神经学检查。

Abstract: Objective: Study the effects of intravenous anesthesia and combined intravenous and inhalation anesthesia on arousing time and recovery quality in spinal surgery.Methods: 55 patients（ASA I-II） were divided randomly into 3 groups: group PR（propofol-remifentanil）: target-controlled infusion with propofol（plasma concentration,2-4 μg·mL^-1） and remifentanil 0.2-0.4 μg·kg^-1·min^-1;group DR（desflurane-remifentanil）: desflurane/air 3.0-4.0 Vol% combined with remifentanil 0.2-0.4 μg·kg^-1·min^-1;and group PFN（propofol-fentanyl-N₂O）: target-controlled infusion with propofol（plasma concentration,2-4 μg·mL^-1）,N₂O（N₂O∶O₂= 1∶1）,and repetitive boluses of 1-2 μg·kg-1 of fentanyl adjusted to patients requirements.Results: Group PFN required significantly longer times for the onset of breathing（8.9±1.6）min,and motion of the feet （12.3±5.6）min than group PR（6.7±2.1）min,and（9.8±2.4）min,respectively or group DR （5.8±0.6）min,and（6.4±0.9）min,respectively.Conclusion: The anesthetic regimen with desflurane and remifentanil allowed faster awakening during surgery that permitted immediate neurological examination compared with propofol-remifentanil and propofol-fentanyl-N2O.

HTML全文

参考文献(0)

施引文献

资源附件(0)