摘要目的 探讨丙泊酚复合瑞芬太尼全凭静脉麻醉在美容手术中的麻醉效果和可控性.方法 选择美国麻醉师协会(ASA)Ⅰ-Ⅱ级住院择期美容手术100例,完全随机分为丙泊酚复合瑞芬太尼全凭静脉麻醉组(T组)和静吸复合麻醉组(C组),各50例.观察受术者术中心血管药物使用和体动发生情况,术毕苏醒、拔管、离室时间、术后不良反应、低氧血症(血氧饱和度＜95％)发生情况以及麻醉满意度.结果 C组苏醒时间、拔管时间、离室时间分别为(12.2±3.6)、(13.8±4.6)、(18.3士5.8)min,均长于T组(6.7±2.6)、(7.8±3.3)、(9.6±3.8) min,差异有统计学意义(P＜0.05).T组术中麻黄碱使用率及体动发生率分别为12.0％(6/50)、8.0％(4/50),均高于C组2.0％(1/50)、2.0％(1/50),差异有统计学意义(P＜0.05).T组术后不良反应发生率较低,其中嗜睡、烦躁、恶心呕吐发生率分别为4.0％(2/50)、2.0％(1/50)、16.0％(8/50),明显低于C组16.0％(8/50)、14.0％(7/50)、34.0％(17/50),差异有统计学意义(P＜0.05).两组术后寒战发生率差异无统计学意义(P＞0.05).C组术后麻醉满意为52.0％(26/50),低于T组的84.0％ (42/50),差异有统计学意义(P＜0.05).结论 丙泊酚复合瑞芬太尼全凭静脉麻醉效果确切,术后麻醉恢复快,不良反应及并发症少,安全、可操作.

abstractsObjective To explore the effect of propofol-remifentanil total intravenous anesthesia in cosmetic surgery and the controllability of anesthesia.Methods According to the American Society of Anesthesiologists (ASA),levels Ⅰ-Ⅱ hospitalized patients for elective cosmetic surgery (100 cases) were randomly divided into two groups,namely propofol-remifentanil total intravenous anesthesia group (Group T) and combined intravenous inhalational anesthesia group (Group C),50 cases each.Observatory items of patients included intraoperative cardiovascular drug use,body movement,waking-up time,extubation time,leaving time from operation theatre,postoperative adverse reaction,hypoxemia (SpO2＜95％) and anesthesia satisfaction.Results In Group C,waking-up time,extubation time and leaving time from operation theatre were (12.2 ± 3.6),(13.8± 4.6) and (4.6 ±5.8) min,respectively,which were longer than those (6.7±2.6),(7.8±3.3) and (3.3±3.8) min in Group T (P＜0.05).In Group T,intraoperative ephedrine usage (6/50,12.0％) and body moving rates (4/50,8.0％) were higher than those (1/50,2.0％) and (1/50,2.0％) in the Group C (P＜0.05).The Group T had lower incidence of postoperative adverse reactions,including lethargy (2/50,4.0％),irritability (1/50,2.0％),nausea and vomiting (8/50,16.0％),which were lower than those (8/50,16.0％),(7/50,14.0％) and (17/50,34.0％) in the Group C (P＜0.05).The incidence of postoperative chill was similar between the two groups with no statistical significance (P＞0.05).Satisfactory rate with anesthesia was 84.0％ (42/50) in Group T that was higher than 52.0％ (26/50) in Group C (P＜0.05).Conclusions Propofol-remifentanil intravenous anesthesia has definite effects with faster postoperative recovery,less adverse reaction and complications,safety and operablity.