CAJ | 학술논문

目的：：观察靶控输注瑞芬太尼对全麻患者苏醒期心血管反应的影响。方法：选择ASAⅠ~Ⅱ级,择期腰椎手术患者60例,随机分为瑞芬太尼组(R组)和对照组(C组)各30例,R组手术结束后持续靶控输注瑞芬太尼(4 ng/ml)直至气管拔管时停药；C组手术结束时即停止输注瑞芬太尼。观察2组患者麻醉前( T1)、拔管时( T2)、拔管后1 min( T3)、拔管后3 min( T4)及拔管后5 min( T5)的血压、心率,记录患者自主呼吸恢复时间、拔管时间、躁动呛咳等心血管不良事件的发生及拔管后不良记忆的患者例数。结果：与R组比较,C组T2、T3、T4、T5时间点血压均明显升高,心率均显著增快(P<0.01)；2组患者呼吸恢复及拔管时间差异均无统计学意义(P>0.05),苏醒时躁动呛咳等心血管不良事件中C组明显增加(P<0.01),拔管后有不良记忆例数C组明显多于R组(P<0.01)。结论：瑞芬太尼4 ng/ml靶控输注能安全有效地减轻全麻患者苏醒期心血管反应,有利于血流动力学稳定,提高患者舒适度。
목적：：관찰파공수주서분태니대전마환자소성기심혈관반응적영향。방법：선택ASAⅠ~Ⅱ급,택기요추수술환자60례,수궤분위서분태니조(R조)화대조조(C조)각30례,R조수술결속후지속파공수주서분태니(4 ng/ml)직지기관발관시정약；C조수술결속시즉정지수주서분태니。관찰2조환자마취전( T1)、발관시( T2)、발관후1 min( T3)、발관후3 min( T4)급발관후5 min( T5)적혈압、심솔,기록환자자주호흡회복시간、발관시간、조동창해등심혈관불량사건적발생급발관후불량기억적환자례수。결과：여R조비교,C조T2、T3、T4、T5시간점혈압균명현승고,심솔균현저증쾌(P<0.01)；2조환자호흡회복급발관시간차이균무통계학의의(P>0.05),소성시조동창해등심혈관불량사건중C조명현증가(P<0.01),발관후유불량기억례수C조명현다우R조(P<0.01)。결론：서분태니4 ng/ml파공수주능안전유효지감경전마환자소성기심혈관반응,유리우혈류동역학은정,제고환자서괄도。
Objective:To explore the effects of the target-controlled infusion(TCI) of remifentanil on the cardiovascular reaction during general anesthesia recovery period. Methods:Sixty ASAⅠ-Ⅱ patients scheduled by lumber operation were randomly divided into the remifentanil group(group R,30 cases) and control group(group C,30 cases). The 4 ng/ml of remifentanil was continuously injected into the group R by TCI from the end of operation to the tracheal extubation,the injection of remifentanil in group C stopped at the end of operation. The blood pressure,heart rate,the time of breath recovery and extubation,move restlessly and bucking and the number of patients with bad memories in two groups before anesthesia( T1 ) ,at the time of extubation( T2 ) ,and after 1 min( T3 ) ,3 min ( T4 ) ,and 5 min( T5 ) of extubation were recorded. Results:Compared with the group R,the blood pressure and heart rate in group C were significantly increased at T2,T3,T4 and T5(P<0. 01),the incidence rate of move restlessly and bucking in group C at waking up was significantly increased(P<0. 01). The differences of the time of breath recovery and extubation between two groups were not statistically significant(P>0. 05). The number of patients with bad memories in group C after extubation were significantly higher than those in group R(P<0. 01). Conclusions:The treatment of 4 ng/ml of remifentanil by TCI can effectively relieve the cardiovascular reaction during general anesthesia recovery period,steady bloodstream dynamics and improve the comfort level of patients.