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阮侠, 刘薇, 谭刚, 崔旭蕾, 黄宇光. 全凭静脉麻醉在青少年脊柱侧弯手术唤醒试验中的应用[J]. 协和医学杂志, 2011, 2(2): 147-150. DOI: 10.3969/j.issn.1674-9081.2011.02.012
引用本文: 阮侠, 刘薇, 谭刚, 崔旭蕾, 黄宇光. 全凭静脉麻醉在青少年脊柱侧弯手术唤醒试验中的应用[J]. 协和医学杂志, 2011, 2(2): 147-150. DOI: 10.3969/j.issn.1674-9081.2011.02.012
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Xia RUAN, Wei LIU, Gang TAN, Xu-lei CUI, Yu-guang HUANG. Effect of Total Intravenous Anesthesia on Wake-up Test in Adolescent Patients Undergoing Scoliosis Surgery[J]. Medical Journal of Peking Union Medical College Hospital, 2011, 2(2): 147-150. DOI: 10.3969/j.issn.1674-9081.2011.02.012
Citation: Xia RUAN, Wei LIU, Gang TAN, Xu-lei CUI, Yu-guang HUANG. Effect of Total Intravenous Anesthesia on Wake-up Test in Adolescent Patients Undergoing Scoliosis Surgery[J]. Medical Journal of Peking Union Medical College Hospital, 2011, 2(2): 147-150. DOI: 10.3969/j.issn.1674-9081.2011.02.012
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全凭静脉麻醉在青少年脊柱侧弯手术唤醒试验中的应用

Effect of Total Intravenous Anesthesia on Wake-up Test in Adolescent Patients Undergoing Scoliosis Surgery

    摘要
  • 摘要:
      目的  比较在青少年脊柱侧弯手术中, 丙泊酚复合瑞芬太尼全凭静脉麻醉与异氟烷复合舒芬太尼静吸复合麻醉的唤醒试验时间及苏醒质量。
      方法  32例择期行脊柱侧弯矫正术的10~18岁患者, 随机分入全凭静脉麻醉组(丙泊酚+瑞芬太尼, P组)和静吸复合麻醉组(异氟烷+舒芬太尼, I组), 比较两组患者术中、术后的唤醒时间, 唤醒时的心率、血压变化以及患者的躁动和术中知晓情况。
      结果  P组患者术中唤醒时间(9.2±3.3)min, 较I组(12.5±6.0)min缩短, 但两组比较差异无统计学意义(P=0.066)。手术结束后睁眼时间、手足活动时间和拔管时间, P组患者分别为(11.6±7.8)、(12.6±7.9)和(13.4±8.3)min, 均较I组患者的(19.7±9.8)、(22.9±8.7)和(20.4±8.7)min缩短(P < 0.05)。I组患者术中唤醒时出现躁动的例数较P组增多(P=0.033)。两组患者术中血流动力学变化及术中知晓情况差异无统计学意义(P > 0.05)。
      结论  与异氟烷复合舒芬太尼静吸复合麻醉比较, 采用丙泊酚复合瑞芬太尼全凭静脉麻醉方案可以使患者在术中及术后更快苏醒, 躁动发生较少, 且不增加术中知晓的发生率。

     

    Abstract:
      Objective  To compare the effects of total intravenous anesthesia(TIVA)with propofol-remifentanil and isoflurane-sufentanil on the wake-up test in the scoliosis correction surgery of adolescence.
      Methods  Thirty-two 10-18-year-old patients undergoing elective scoliosis procedures were randomly allocated into two groups:group P(propofol/remifentanil)and group I(isoflurane/sufentanil).The wake-up time and quality during and after the surgery were compared.
      Results  Group P(9.2±3.3 min vs 12.5±6.0 min, P=0.066)required shorter wake-up time during the surgery.The patients in group P had significantly shorter time for the onset of opening eyes(11.6±7.8 min vs 19.7±9.8 min), motion of the feet(12.6±7.9 min vs 22.9±8.7 min), and the extubation(13.4±8.3 min vs 20.4±8.7 min)than those in groug I(P < 0.05).More patients in group I had agitation during the intra-operative wake-up tests(P=0.033).No significant difference was found between the two groups in the incidence of hemodynamic instability or intraoperative awareness.
      Conclusion  The total intravenous anesthesia with propofol and remifentanil can shorten the wake-up time, reduce agitation, and do not induce intra-operative awareness.

     

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