【摘要】 目的观察丙泊酚分别复合芬太尼、瑞芬太尼、布托啡诺用于三叉神经半月节射频热凝术的麻醉效果。方法 60例三叉神经痛行半月神经节射频热凝术的患者,随机均分为3组(每组20例),丙泊酚分别复合芬太尼(A组)、瑞芬太尼(B组)、布托啡诺(C组)进行静脉麻醉。观察并记录不同时点MAP、HR及SpO2的变化,丙泊酚总用量、术后苏醒时间及术中体动、呼吸抑制和心动过缓的发生率,术后随访恶心呕吐的发生率、患者和术者的满意度。结果 3组患者在麻醉诱导后、治疗中MAP均有明显降低(P均<0.05),B组降幅大于A、C组(P均<0.05),术后3组均恢复至接近麻醉前水平。丙泊酚总用量、术后苏醒时间及术中体动发生率B组低于A、C组(P均<0.05),术中呼吸抑制和心动过缓的发生率由高到低依次为B组、A组和C组,但3组间差异无统计学意义(P>0.05)。结论丙泊酚复合不同阿片类药物用于半月节射频热凝术均安全有效,复合瑞芬太尼组术后苏醒快,复合布托啡诺组术中不良反应较少。更多还原

【Abstract】 Objective To compare the anesthetic effects of the propofol combining with fentanyl,remifentanil and butorphanol separately in radiofrequency thermocoagulation of patients with trigeminal neuralgia.Methods A total of 60 patients with trigeminal neuralgia underwent trigeminal semilunar ganglion radiofrequency thermocoagulation were randomly divided into 3 groups(n=20 each):propofol-fentanyl group(group A),propofol-remifentanil group(group B)and propofol-butorphanol group(group C).The indicators were observed and compared,which included:the changes of mean arterial pressure(MAP),heart rate(HR)and pulse oxygen saturation(SpO2)in different time points,the total dose of propofol,postoperative awake time,body movement in the operation,the incidence of respiratory depression and bradycardia,the incidence of nausea and vomiting in the postoperative follow up and the satisfactory degree of intensity of patients and surgeons.Results After induction of anesthesia,all MAP were significantly lowered in 3 groups(all P<0.05),but the fallen degree in group B was bigger than those in groups A and C(all P<0.05).All MAP after operation recovered levels near pre-anesthesia.The total dose of propofol,postoperative awake time and the incidence of body movement in operation in group B were lower than those in groups A and C(all P<0.05).The incidences of respiratory depression and bradycardia waried from high to low as following:B组>A组>C组,but there was no difference between three groups(P>0.05).Conclusion Propofol combining with different analgesics of opiums for intravenous anesthesia in semilunar ganglion radiofrequency thermocoagulation is safe and effective.Propofol combining with remifentanil has quicker postoperative awake time,and with butorphanol has fewer adverse reactions in operation.更多还原