【摘要】 目的探讨瑞芬太尼复合丙泊酚静脉麻醉在颅内动脉瘤介入栓塞术中的临床价值。方法 56例颅内动脉瘤择期行介入栓塞术患者,随机分为瑞芬太尼组和芬太尼组各28例,瑞芬太尼组术中血浆靶控瑞芬太尼镇痛,芬太尼组用芬太尼替代瑞芬太尼,皆复合丙泊酚靶控输注维持麻醉,监测麻醉过程各个时段的血流动力学参数:心率(HR)、收缩压(SBP)、舒张压(DBP)和麻醉恢复情况。结果与麻醉前比较,股动脉置管后1 min芬太尼组差异有统计学意义(P<0.05);拔除喉罩时瑞芬太尼组差异有统计学意义(P<0.05)。两组间比较,股动脉置管后1 min、拔除喉罩时血流动力学变化参数差异有统计学意义(P<0.05)。瑞芬太尼组在呼吸恢复、睁眼、拔管时间上明显短于芬太尼组,组间差异有统计学意义(P<0.05)。结论瑞芬太尼复合丙泊酚麻醉应用于颅内动脉瘤介入栓塞术,血流动力学更稳定,术后苏醒更快、更平稳。更多还原

【Abstract】 Objective To investigate the clinical value of remifentanil and propofol in treatment of endovascular embolization of cerebral aneurysm.Methods 56 patients of cerebral aneurysm,which need endovascular embolization,were randomly divided into two groups: remifentanil group and fentanyl group.Changes of haemodynamics parameter and palinesthesia were observed and recorded continuously during every period of operation.Results Compared with the value of before anesthesia,hemodynamics of two groups obviously declined in 1 minute after inserted laryngeal mask.Hemodynamics of fentanyl group significantly increased in 1 minute after inserted tube into arteria femoralis.hemodynamics of remifentanyl group significantly increased after removing laryngeal mask.The hemodynamics in 1 minute after inserted tube into arteria femoralis and removing laryngeal mask were significantly different between two groups.Recovery of anesthesia palinesthesia time were shorter in remifentanil group than those in fentanyl group.There were fewer restlessness in the remifentanil group(P<0.05).Conclusion Remifentanil can be more efficient than fentanyl in vein anesthesia of endovascular embolization of cerebral aneurysm,including stable hemodynamics,fast metabolism and profit to early analepsia.更多还原