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目的探讨舒芬太尼-瑞芬太尼联合镇痛全麻用于口腔颌面外科手术的效果,可行性和安全性。方法60例口腔颌面外科手术患者随机分为3组:瑞芬太尼组(RF组)、舒芬太尼组(SF组)、舒芬太尼联合瑞芬太尼组(SR组)。记录苏醒期拔管时间、拔管时心率和血压、麻醉时间及各阿片类麻醉药用量、患者拔管后即刻及离开恢复室时的伤口疼痛程度,苏醒期躁动的例数。结果 SR组患者离开PACU时疼痛评分明显低于RF组(P<0.05);SR组术毕拔管时间、恢复室停留时间明显短于SF组(P<0.05);拔管后10min呼吸频率明显快于SF组(P<0.05);SR组苏醒时及离开PACU时MAP和HR明显低于RF组(P<0.05)。结论舒芬太尼与瑞芬太尼联合用于口腔颌面外科手术的全麻中,可使术中血流动力学平稳、苏醒期安全迅速。
Objective To investigate the efficacy, feasibility and safety of sufentanil combined with remifentanil in general anesthesia for oral and maxillofacial surgery. Methods Sixty patients undergoing oral and maxillofacial surgery were randomly divided into three groups: remifentanil (group RF), sufentanil (group SF), sufentanil combined with remifentanil (group SR). The time of extubation during recovery, the heart rate and blood pressure during extubation, the time of anesthesia and the amount of opioid anesthesia, the degree of pain in the wound immediately after extubation and the time of leaving the recovery room, and the number of restlessness in recovery period were recorded. Results The pain score in SR group was significantly lower than that in RF group when left PACU (P <0.05). The time of extubation and residence time in SR group was significantly shorter than that in SF group (P <0.05), and the respiratory rate ten minutes after extubation (P <0.05). The MAP and HR in SR group were significantly lower than those in RF group at wake and PACU (P <0.05). Conclusion Sufentanil combined with remifentanil for general anesthesia in oral and maxillofacial surgery can make intraoperative hemodynamics stable and safe during recovery.