全麻苏醒拔管期间维持小剂量瑞芬太尼靶控输注可改善苏醒拔管质量

基础医学与临床 ›› 2014, Vol. 34 ›› Issue (1): 109-112.

全麻苏醒拔管期间维持小剂量瑞芬太尼靶控输注可改善苏醒拔管质量

王静捷¹,陈广俊¹,罗爱伦²,黄宇光¹

1. 北京协和医院
2. 中国医学科学院北京协和医学院北京协和医院麻醉科

收稿日期:2013-09-26 修回日期:2013-11-18 出版日期:2014-01-05 发布日期:2013-12-26
通讯作者: 黄宇光 E-mail:garybeijing@163.com

Maintaining a remifentanil target infusion can improve the quality of recovery profiles during emergence from general anesthesia and tracheal extubation

Received:2013-09-26 Revised:2013-11-18 Online:2014-01-05 Published:2013-12-26

摘要/Abstract

摘要： 目的探讨丙泊酚联合瑞芬太尼全凭静脉麻醉患者全麻苏醒期间维持小剂量瑞芬太尼靶控输注对苏醒拔管质量的影响。方法择期脊柱侧弯后路矫形手术患者40例，随机分为对照组（全麻苏醒期间停用所有药物，n=20）和瑞芬太尼组（全麻苏醒期间维持瑞芬太尼小剂量靶控输注，n=20）。记录两组患者苏醒时间、拔管时间，并观察苏醒拔管质量评分。结果对照组患者苏醒时间为（12.76±3.56）min，拔管时间为（13.98±4.06）min；瑞芬太尼组患者苏醒时间为（13.14±3.87）min，拔管时间为（14.21±4.77）min，组间比较无显著差异。但对照组患者苏醒拔管质量评分为1、2、3、4和5分的患者例数分别为1、10、5、3和1例；瑞芬太尼组患者苏醒拔管质量评分为1、2、3、4和5分的患者例数分别为5、12、3、0和0例，组间比较有显著差异（P<0.05）。结论丙泊酚联合瑞芬太尼全凭静脉麻醉全麻苏醒拔管期间维持小剂量瑞芬太尼靶控输注可以改善苏醒拔管质量，且不延长苏醒拔管时间。

关键词: 瑞芬太尼, 靶控输注, 拔管, 恢复

Abstract: Objective To explore whether maintaining low dose remifentanil target controlled infusion (TCI) during emergence from general anesthesia can improve the quality of recovery profiles for the patients under total intravenous anesthesia with propofol and remifentanil. Methods Forty elective scoliosis surgical patients were randomized into two groups: control group (n=20, all anesthetic drugs paused during emergence) and remifentanil group (n=20, maintaining low dose remifentanil target controlled infusion while propofol infusion paused during emergence). Awake time, tracheal extubation time and quality score of recovery status were recorded. Results Awake time and tracheal extubation time were (12.76±3.56) min and (13.98±4.06) min respectively in control group, while it were (13.14±3.87) min and (14.21±4.77) min respectively in remifentanil group. There was no significant difference of awake and tracheal extubation time between two groups. However, the patient number with quality score of recovery status 1/2/3/4/5 in control group were 1/10/5/3/1 respectively, while it were 5/12/3/0/0 respectively in remifentanil group (P<0.05). Conclusions Maintaining low dose remifentanil target controlled infusion during emergence from general anesthesia can improve recovery quality and does not prolong awake time and tracheal extubation time for the patients under total intravenous anesthesia with propofol and remifentanil.

Key words: remifentanil, target controlled infusion, extubation, recovery

中图分类号:

中图分类号：R614.2+4

王静捷陈广俊罗爱伦黄宇光. 全麻苏醒拔管期间维持小剂量瑞芬太尼靶控输注可改善苏醒拔管质量[J]. 基础医学与临床, 2014, 34(1): 109-112.

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