舒芬太尼与瑞芬太尼在小儿脊柱侧弯手术的联合应用-中华医学会麻醉学.docVIP

舒芬太尼与瑞芬太尼在小儿脊柱侧弯手术唤醒中的联合应用 毛珍慧 王萍 张建敏 首都医科大学附属北京儿童医院麻醉科 北京 100045 [摘要] 目的 比较舒芬太尼联合瑞芬太尼与芬太尼联合瑞芬太尼用于脊柱侧弯矫形手术麻醉对术中唤醒试验的影响。方法ASAⅠ～Ⅱ级脊柱侧凸后路矫形手术患者 40例 ,随机分为Ⅰ 组 (n =20)和 Ⅱ组 (n =20)。Ⅰ组用舒芬太尼1μg/kg诱导。Ⅱ组用芬太尼5μg /kg诱导，两组术中吸入七氟醚及笑气，持续静脉泵入瑞芬太尼维持麻醉.记录唤醒时间,呼气末七氟醚浓度 (ETsev),唤醒期间血流动力学变化以及唤醒期躁动呛咳例数等。结果 两组唤醒期间血液动力学变化无显著差异。Ⅰ组患者唤醒时间短于Ⅱ组，唤醒期间呛咳躁动发生率低于Ⅱ组。结论 舒芬太尼联合瑞芬太尼应用于脊柱侧弯手术唤醒试验中能够缩短唤醒时间，唤醒质量高, 更适用于脊柱手术。 关键词 舒芬太尼, 瑞芬太尼, 脊柱侧弯, 唤醒试验, 麻醉 Application of sufentanil combining with remifentanil on wake-up test in anesthesia for scoliosis surgery Mao Zhen-Hui, Wang Ping, Zhang Jian-Min Beijing Children’s Hospital, Beijing 100045, [Abstract] Objective: To compare the effects of sufentanil combining with remifentanil and fentanyl combining with remifentanil on wake-up test in scoliosis surgery. Methods: Forty ASAⅠ～ⅡPatients undergoing scoliosis surgery were randomly divided into sufentail combining with remifentail group(groupⅠ,n=20) and fentanyl combining with remifentanil group(groupⅡ,n=20), sufentanil1μg /kg was used in groupⅠwhile fentanyl 5μg/kg was used in groupⅡ, The anesthesia was maintained with inhaling sevoflurane and nitrous oxide and continuous intravenous infusion of remifentanil in both groups.The wake-up test time, end-tidal sevoflurane concentration, bucking and restlessness and hemodynamic variables including MAP and HR during the wake-up test were recorded. Results: There were stable circulatory functions during the wake-up test time in both groups. The wake-up test time in groupⅠwere significantly earlier than those in groupⅡ. Compared with groupⅡ, fewer bucking and restlessness happened during the wake-up test in groupⅠ. Conclusion: Sufentanil combining with remifentanil can shorten the intraoperative wake-up test time, have a good quality of wake- up test. So it is an appropriate anesthetic technique for scoliosis surgery. [Key Words] sufentanil; remifentanil; scoliosis; wake- up tes