| 司马靓杰1 王胜2 郭素香2.瑞芬太尼、芬太尼及瑞芬太尼- 芬太尼联合应用对肥胖患者麻醉
后苏醒质量的研究[J].,2011,11(5):909-914 |
| 瑞芬太尼、芬太尼及瑞芬太尼- 芬太尼联合应用对肥胖患者麻醉
后苏醒质量的研究 |
| A comparative study in obese patients on recovery quality of administratingfentanyl , remifentanil and remifentainil combined fentanyl in generalanaesthesia |
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| DOI： |
| 中文关键词: 肥胖 联合应用 苏醒质量 |
| 英文关键词: obese joint application recovery quality |
| 基金项目: |
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| 摘要点击次数: 942 |
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| 中文摘要: |
| 目的：探讨芬太尼和瑞芬太尼分别应用于肥胖患者全身麻醉中苏醒质量的优缺点，对比研究两药联合应用对于提高肥胖患
者苏醒质量的可行性和有效性。方法：60 例体重指数>30 的肥胖患者随机分为三组，分别应用芬太尼（F 组）、瑞芬太尼（R 组）和
瑞芬太尼联合应用芬太尼（RF 组）进行全身麻醉，麻醉时间2 小时左右，从停止用药开始分别观察BIS 值恢复时间，睁眼时间，
5mi/kg 潮气量恢复时间，每分通气量恢复时间，拔管时血压，定向力恢复时间，进行视觉模拟评分和镇静/ 警觉评分和拔管后动脉
血气的测量。结果：RF 组和R 组的BIS 值恢复时间和睁眼时间及每分通气量恢复时间无差异，均优于F 组。而且RF 组和R 组中
BIS 值恢复时间和睁眼时间相关性良好，F 组中两指标无相关性。停药后三组患者分别进行1 小时、2 小时4、4 小时和24 小时的
VAS 评分和OAA/S 评分，VAS 评分中R 组在四个时相于其他两组比较均有统计学意义（P<0.05），均较两组高，F 组和RF 组在手
术后1、2 小时时相上比较无统计学意义（P>0.05）。OAA/S 评分中，F 组在1、2 及4 小时三个时相均低于其他组，R 组和RF 组在四
个时相比较均无统计学意义（P>0.05）。定向力恢复时间三组比较，R 组和RF 组之间无统计学意义（P>0.05），F 组均与其他两组有
差别，且长于其他两组（P<0.05）。血气分析结果中RF 组优于其他组（P<0.05）。全麻后的副反应中RF 组的发生率较低。结论：瑞
芬太尼联合应用芬太尼对于肥胖患者全身麻醉意识恢复快，通气恢复时间短，镇痛效果好，血流动力学平稳，苏醒质量高。 |
| 英文摘要: |
| Objective: To make a comparative study on the advantages and disadvantages of using fentanyl and remifentanil.,To
evaluate the effectiveness and the feasibility of joint application to improve the recovery quality。Methods: Sixty obese patients receiving
gerenal anaesthesia were randomly divided into three groups:R,F and group RF. Anesthesia time about two hours.In stage of analepsia,To
observe the following targets:The recovery time of BIS, directive force, minute ventilation and tidal volume (5ml/kg).The time of
awakening and extubation.To measure blood pressure in the time of extubation. and blood gas after extubation for thirty minutes.To
record the alertness/sedation score (OAA/S) and visual simulation score (VAS) in different time point..Results: In three groups, The
recovery time of directive force and minute ventilation and the time of awakening and extubation was shorter in group R and group RF
than in group F. There was no sigmificant difference in the recovery time of BIS and the recovery time of BIS in three groups.The
correlation of the recovery time of BIS and the time of awakening is sigmificant in group R and group RF. The OAA/ S scores were
significantly greater in group R and group RF than in group F at the time point after trachea extubation for one hour,two hours and four
hours. The VAS scores were significantly greater in group R than in group R and group RF at the time point after trachea extubation for
one hour and two hours. The incidence of postoperative side effects was lower in group RF than group R and F.Conclusion: Application
of remifentainil combined fentanyl have better recovery quality for obese patients in general anaesthesia. |
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