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小剂量瑞芬太尼减少腭咽成形术后全麻苏醒期呛咳反射的发生

张洁 王勇 张卫 中国实用医刊 2010年第11期

摘要:目的 观察腭咽成形术后全麻苏醒期静脉输注小剂量瑞芬太尼的效果和不良反应.方法 60例择期行腭咽成形术病人随机分为两组,丙泊酚、芬太尼和阿曲库铵诱导插管后,术中吸入七氟醚复合静脉输注瑞芬太尼维持麻醉.手术结束后,瑞芬太尼组继续经静脉输注瑞芬太尼,速率为0.05 μg/(kg·min);对照组改为静脉输注生理盐水直至拔管后.观察并记录两组病人全麻苏醒期呛咳反射、呼吸抑制和深度镇静的发生率.结果 瑞芬太尼组28例,对照组29例病人完成本研究.瑞芬太尼组呛咳反射发生率显著低于对照组;呼吸抑制和深度镇静的发生率两组比较差异无统计学意义.结论 0.05 μg/(kg·min)瑞芬太尼静脉输注能减少腭咽成形术后苏醒期呛咳反射的发生,且不增加不良反应. Abstract: Objective To investigate the effect of small dose remifentanil infusion during emergence of anaesthesia after uvulopalatopharyngoplasty (UPPP). Methods Sixty patients scheduled for UPPP were randomly divided into two groups.All patients received propofol,fentanyl and atracurium for induction and intubation.After intubation,sevoflurane inhalation and remifentanil infusion were administered for maintenance of anaesthesia.After operation,remifentanil infusion was continued at a rate of 0.05 μg/(kg·min) in the remifentanil group,while saline was infused in the control group until extubation.The incidence of coughing,respiratory depression and deep sedation were observed and recorded. Results Twenty-eight patients in the remifentanil group and 29 patients in the control group completed the study.The incidence of coughing was significantly lower in the remifentnail group.There was no significant differences in the incidence of respiratory depression or deep sedation between the two groups. Conclusions 0.05 μg/(kg·min) Remifentanil infusion is effective for reducing the incidence of coughing during emergence of anaesthesia after UPPP without increasing incidence

关键词:小剂量瑞芬太尼咽成形术后全麻苏醒期呛咳反射

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