【摘要】 目的:探讨雷米芬太尼在老年高血压患者腮腺肿瘤手术中的临床应用价值。方法:选择拟行腮腺肿瘤手术的高血压患者52例,年龄65～82岁,ASAⅡ或Ⅲ级,随机分成雷米芬太尼组(R)和芬太尼组(F),每组26例。2组均采用全凭静脉麻醉,诱导方法一致。术中R组持续泵入雷米芬太尼0.05～0.2μg/kg.min-1,F组间断给予芬太尼,最大用量不超过8.0g/kg。2组均以丙泊酚和顺式阿曲库铵维持麻醉。记录不同时间点血流动力学参数、术后恢复情况及早期不良反应。结果:R组术中血流动力学更平稳,出血量少,术后苏醒时间和拔管时间较F组显著缩短(P<0.01)。2组患者自主呼吸恢复时间、术后躁动、疼痛和恶心呕吐发生率差异无统计学意义。结论:老年高血压患者行腮腺手术时,采用雷米芬太尼麻醉可维持血流动力学稳定,减少术野出血,提高患者苏醒质量,具有较高的安全性和临床实用性。更多还原

【Abstract】 Objective: To explore the clinical application of remifentanil in aged patients with hypertension undergoing parotid tumor surgery.Methods: 52 patients,aged 65-82 years,ASAⅡ or Ⅲ,were randomly divided into group R and group F with 26 cases each group.Both groups were given total intravenous anesthesia with consistent induction approach.Patients in group R were continuously infused with remifentanil 0.05-0.2μg/kg·min-1 whereas those in group F were given fentanyl intermittently with the maximum dose 8.0g/kg during operation.Anesthesia was maintained with propofol and cis-atracurium in the two groups.Hemodynamic parameters,postoperative recovery and early adverse effects were recorded at different time points.Results: The patients in group R had more stable hemodynamics and less volume of blood loss compared with those in group F.Postoperative awake time and extubation time were significantly reduced in R group than those in group F(P<0.01).There were no significant differences in recovery time of spontaneous breathing,postoperative restlessness,pain,nauseau and vomitting in two groups.Conclusion: Remifentanil is safe and practicable clinically for aged patients with hypertension undergoing parotid tumor surgery as it can maintain hemodynamics stable,decrease the volume of blood loss and provide a better awakeness.更多还原