中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2013年
10期
1085-1087
,共3页
瑞芬太尼%芬太尼%老年%麻醉
瑞芬太尼%芬太尼%老年%痳醉
서분태니%분태니%노년%마취
Remifentanil%Fentanyl%Elder%patients%Anesthesia
目的 比较瑞芬太尼与芬太尼在老年前列腺电切术麻醉中的效果.方法 选取我院80例进行前列腺电切手术的老年患者(年龄≥60岁),随机分为瑞芬太尼组(R组40例)和芬太尼组(F组40例).R组和F组分别使用瑞芬太尼和芬太尼进行麻醉诱导和维持.观察比较麻醉前后血流动力学(血压、心率)变化、术后恢复情况(自主呼吸恢复时间、睁眼恢复时间、拔管时间)及术后24 h内不良反应(术中知晓、恶心、呕吐).结果 R组麻醉后收缩压、心率均低于麻醉前,且低于F组,组间差异有统计学意义(收缩压:F组内=58.306、P组内=0.000,F姬=142.450、P交互=0.000,F组间=7.417、P组间=0.010;心率:F组内=41.512、P组内=0.000,F交互=269.103、P交互=0.000,F组间=39.703、P组间=0.000.R组自主呼吸恢复时间、睁眼恢复时间及拔管时间均短于F组,组间差异有统计学意义[自主呼吸恢复时间:(7.5±1.3) min与10.7±3.1)min,t=3.011,睁眼恢复时间(13.5±3.2) min与(18.3±5.2) min,t=2.611,拔管时间(24.4±5.5) min与(29.2±7.1)min,t=2.696;P均＜0.05].两组术后24 h内恶心、呕吐概率,比较差异均无统计学意义(P均＞0.05),两组均无术中知晓.结论 瑞芬太尼在老年前列腺电切术麻醉中比芬太尼安全有效,且术后恢复快,是该手术麻醉的理想用药.
目的 比較瑞芬太尼與芬太尼在老年前列腺電切術痳醉中的效果.方法 選取我院80例進行前列腺電切手術的老年患者(年齡≥60歲),隨機分為瑞芬太尼組(R組40例)和芬太尼組(F組40例).R組和F組分彆使用瑞芬太尼和芬太尼進行痳醉誘導和維持.觀察比較痳醉前後血流動力學(血壓、心率)變化、術後恢複情況(自主呼吸恢複時間、睜眼恢複時間、拔管時間)及術後24 h內不良反應(術中知曉、噁心、嘔吐).結果 R組痳醉後收縮壓、心率均低于痳醉前,且低于F組,組間差異有統計學意義(收縮壓:F組內=58.306、P組內=0.000,F姬=142.450、P交互=0.000,F組間=7.417、P組間=0.010;心率:F組內=41.512、P組內=0.000,F交互=269.103、P交互=0.000,F組間=39.703、P組間=0.000.R組自主呼吸恢複時間、睜眼恢複時間及拔管時間均短于F組,組間差異有統計學意義[自主呼吸恢複時間:(7.5±1.3) min與10.7±3.1)min,t=3.011,睜眼恢複時間(13.5±3.2) min與(18.3±5.2) min,t=2.611,拔管時間(24.4±5.5) min與(29.2±7.1)min,t=2.696;P均＜0.05].兩組術後24 h內噁心、嘔吐概率,比較差異均無統計學意義(P均＞0.05),兩組均無術中知曉.結論 瑞芬太尼在老年前列腺電切術痳醉中比芬太尼安全有效,且術後恢複快,是該手術痳醉的理想用藥.
목적 비교서분태니여분태니재노년전렬선전절술마취중적효과.방법 선취아원80례진행전렬선전절수술적노년환자(년령≥60세),수궤분위서분태니조(R조40례)화분태니조(F조40례).R조화F조분별사용서분태니화분태니진행마취유도화유지.관찰비교마취전후혈류동역학(혈압、심솔)변화、술후회복정황(자주호흡회복시간、정안회복시간、발관시간)급술후24 h내불량반응(술중지효、악심、구토).결과 R조마취후수축압、심솔균저우마취전,차저우F조,조간차이유통계학의의(수축압:F조내=58.306、P조내=0.000,F희=142.450、P교호=0.000,F조간=7.417、P조간=0.010;심솔:F조내=41.512、P조내=0.000,F교호=269.103、P교호=0.000,F조간=39.703、P조간=0.000.R조자주호흡회복시간、정안회복시간급발관시간균단우F조,조간차이유통계학의의[자주호흡회복시간:(7.5±1.3) min여10.7±3.1)min,t=3.011,정안회복시간(13.5±3.2) min여(18.3±5.2) min,t=2.611,발관시간(24.4±5.5) min여(29.2±7.1)min,t=2.696;P균＜0.05].량조술후24 h내악심、구토개솔,비교차이균무통계학의의(P균＞0.05),량조균무술중지효.결론 서분태니재노년전렬선전절술마취중비분태니안전유효,차술후회복쾌,시해수술마취적이상용약.
Objective To compare the anesthetic effects of remifentanil and fentanyl in elderly patient undergoing transurethral electro-vaporization of the prostate.Methods Eighty cases of the elderly patients (age ≥60 years) with transurethral resection of the prostate operation in the hospital were randomly divided into remifentanil group(R group,n =40) and fentanyl group (F group,n =40).Patients in R group and F group were administrated remifentanil and fentanyl respectively for induction and maintenance of anesthesia.The following indices were recorded including the changes of emodynamics (lood pressure,heart rate) in before-and after-anesthesia,postoperative recovery (spontaneous breathing recovery time,open the recovery time,extubation time) and the adverse reaction within 24 hours after operation (awareness during operation,nausea,vomiting).Results Blood pressures,heart rate of after-anesthesia in R group were lower than that in before-anesthesia and F group,the difference were significant(Blood pressures:F within group =58.306,P within group =0.000,F interactive group =142.450,p interactive group =0.000,F between group =7.417,P between group =0.010;heart rate:F within group =41.512,P within group =0.000,F interactive group =269.103,P interactive group =0.000,F between grouP =39.703,P between group =0.000).Spontaneous breathing recovery time,opening eye time and extubation time in group R were significantly shorter than that of F group (Spontaneous breathing recovery time:(7.5 ± 1.3) min vs.(10.7 ± 3.1) min,t =3.011 ; Opening eye time:(13.5 ± 3.2) min vs.(18.3 ± 5.2) min,t =2.611 ; Extubation time:(24.4 ± 5.5) min vs.(29.2 ± 7.1) min,t =2.696 ; all P ＜ 0.05).No significant differences were found in R and F group in terms of intraoperative awareness postoperative nausea,vomiting (P ＞ 0.05).Conclusion Remifentanil used in elderly patients with transurethral electro-vaporization of the prostate was safer and more effective than fentanyl.Meanwhile postoperative recovery in Remifentanil patient was more rapidly.Therefore Remifentanil was ideal drug during the process clinical anesthesia.
