靶控输注瑞芬太尼与芬太尼对颅内肿瘤患者的麻醉效果比较

目的比较瑞芬太尼与芬太尼靶控输注法静脉全麻对颅内肿瘤患者的麻醉效果。方法 60例择期行颅内肿瘤切除患者随机分为瑞芬太尼组（R组）和芬太尼组（F组）,每组30例,分别采用异丙酚＋瑞芬太尼、异丙酚＋芬太尼靶控输注,测量诱导前（T1）、插管前即刻（T2）、插管后即刻（T3）、切皮（T4）、切开硬脑膜时（T5）及拔管时（T6）的平均动脉压（MAP）和心率（HR）,并记录呼之睁眼时间、拔管时间、定向力恢复时间和Aldrete麻醉恢复评分≥9的时间。结果与R组比较,F组的MAP和HR在T3、T4和T5时点显著升高（P〈0.01或0.05）,呼之睁眼时间、拔管时间、定向力恢复时间和Aldrete麻醉恢复评分≥9的时间显著延长（P〈0.01）。结论靶控输注瑞芬太尼比芬太尼可更好地维持颅内肿瘤切除术期间血流动力学稳定,术后患者苏醒更迅速。

Comparative effect of target controlled infusion of remifentanil and fentanyl on patients with intracranial tumor

Objective To compare the effect of target controlled infusion of remifentanil and fentanyl on patients with intracranial tumor. Methods Sixty patients undergoing elective resection of intracranial tumor were randomly divided into remifentanil and fentanyl groups, receiving target controlled infusion of propofol plus remifentanil, and propofol plus fentanyl, respectively. Mean arterial pressure （MAP） and heart rate （HR） were detected before induction （T1）, immediately before intubation （T2） and after intubation （T3）, and on skin incision （T4）, dural incision （T5） and extubation （T6）, and duration of eye opening at request, tracheal extubation, orientation and Aldrete score ≥ 9 was also recorded. Results Compared with remifentanil group, MAP and HR in fentanyl group increased remarkably at T3, T4 and T5 （P0.01 or 0.05）, while duration of eye opening at request, tracheal extubation, orientation and Aldrete score ≥ 9 significantly was longer （P0.01）. Conclusion Targetcontrolled infusion of remifentanil is superior to fentanyl in maintenance of hemodynamic stability and restoration of postoperative consciousness during intracranial tumor surgery.