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目的探讨瑞芬太尼复合丙泊酚靶控输注对脑肿瘤手术患者的麻醉效果。方法对2009年8月至2012年12月择期行颅内肿瘤手术的30例患者予以瑞芬太尼复合丙泊酚靶控输注麻醉,作为观察组;另选取同时间段择期行颅内肿瘤手术的30例患者予以芬太尼和丙泊酚的复合麻醉,作为对照组。比较两组患者的麻醉效果。结果对照组患者诱导前、诱导后、插管后、手术开始、术后0.5h和手术结束各时间点的平均动脉压(MAP)与观察组相比,差异无统计学意义(P>0.05)。对照组患者诱导后、插管后、手术开始、术后0.5h和手术结束各时间点的心率(HR)均高于观察组,差异有统计学意义(P<0.05)。对照组诱导后30min、麻醉后1h、麻醉后2h各时间点的颈内静脉血氧饱和度(SjvO2)均高于观察组,动静脉血氧含量差(Da-jvO2)均低于观察组,差异有统计学意义(P<0.05)。对照组患者的呼吸恢复时间、睁眼时间和拔管时间均明显高于观察组,差异有统计学意义(P<0.05)。结论对脑肿瘤手术患者予以瑞芬太尼复合丙泊酚靶控输注麻醉具有麻醉平稳、苏醒快、血流动力学稳定等优点,且能更好的维持脑氧供需平衡。
Objective To investigate the anesthetic effect of remifentanil combined with propofol target controlled infusion on patients with brain tumor. Methods Thirty patients who underwent intracranial tumor surgery between August 2009 and December 2012 were treated with remifentanil combined with propofol target-controlled infusion as the observation group. In the other group, intracranial tumors Thirty patients undergoing surgery received combined anesthesia with fentanyl and propofol as a control. The effects of anesthesia in two groups were compared. Results Compared with the observation group, there was no significant difference in mean arterial pressure (MAP) between the control group before induction, after induction, after intubation, and at the beginning of surgery, 0.5h after operation and at the end of the operation (P> 0.05) . After intubation, the heart rate (HR) of the control group patients after intubation, beginning of surgery, 0.5h after surgery and at the end of surgery were all significantly higher than those in the observation group (P <0.05). In the control group, the SjvO2 of the jugular vein at 30 min after induction, 1 h after anesthesia and 2 h after anesthesia were all higher than those in the observation group, and the difference of Da-jvO2 in the control group was lower than that in the observation group. The difference was statistically significant (P <0.05). The respiratory recovery time, open-eye time and extubation time in the control group were significantly higher than those in the observation group (P <0.05). Conclusion The target-controlled infusion of remifentanil combined with propofol has the advantages of stable anesthesia, rapid recovery and stable hemodynamics in brain tumor surgery patients, and can better maintain the balance between cerebral oxygen supply and demand.