瑞芬太尼与芬太尼用于颈动脉内膜切除术患者的比较。

A comparison of remifentanil and fentanyl in patients undergoing carotid endarterectomy.

作者信息

Doyle P W, Coles J P, Leary T M, Brazier P, Gupta A K

机构信息

Department of Anaesthesia, Box 93, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, UK.

出版信息

Eur J Anaesthesiol. 2001 Jan;18(1):13-9. doi: 10.1046/j.1365-2346.2001.00763.x.

DOI:10.1046/j.1365-2346.2001.00763.x

PMID:11270004

Abstract

BACKGROUND AND AIM

We investigated the haemodynamic stability and emergence characteristics of isoflurane/nitrous oxide anaesthesia supplemented with remifentanil or fentanyl in patients undergoing carotid endarterectomy.

METHODS

Anaesthesia was induced with propofol (1-2 mg kg-1) and either remifentanil (0.5 microgram kg-1) or fentanyl (1 microgram kg-1), followed by an infusion of remifentanil (0.2 microgram kg-1 min-1) or fentanyl (2 micrograms kg-1 h-1).

RESULTS

There were no significant differences between the groups in haemodynamic variables, postoperative pain, nausea or vomiting. After induction there was a significant decrease in mean arterial pressure for both groups (P < 0.001) and a decrease in heart rate (P = 0.001) in the remifentanil group. In both groups these haemodynamic changes continued during maintenance of anaesthesia (P < 0.05). The time to eye opening after surgery was significantly shorter with remifentanil compared with fentanyl (6.62 +/- 3.89 vs. 18.0 +/- 15.18 min, P = 0.015).

CONCLUSION

Remifentanil appears to be a comparable opioid to fentanyl when supplementing isoflurane/nitrous oxide anaesthesia for carotid endarterectomy.

摘要

背景与目的

我们研究了在接受颈动脉内膜切除术的患者中，异氟烷/氧化亚氮麻醉联合瑞芬太尼或芬太尼时的血流动力学稳定性和苏醒特征。

方法

用丙泊酚（1 - 2毫克/千克）和瑞芬太尼（0.5微克/千克）或芬太尼（1微克/千克）诱导麻醉，随后输注瑞芬太尼（0.2微克/千克·分钟）或芬太尼（2微克/千克·小时）。

结果

两组在血流动力学变量、术后疼痛、恶心或呕吐方面无显著差异。诱导后两组平均动脉压均显著降低（P < 0.001），瑞芬太尼组心率降低（P = 0.001）。在麻醉维持期间，两组这些血流动力学变化持续存在（P < 0.05）。与芬太尼相比，瑞芬太尼组术后睁眼时间显著缩短（6.62 ± 3.89对18.0 ± 15.18分钟，P = 0.015）。