Guo Xiangyang, Yi Jie, Ye Tiehu, Luo Ailun, Huang Yuguang, Ren Hongzhi
Department of Anesthesiology, Peking Union Medical College Hospital, Beijing 100730, China.
Chin Med J (Engl). 2003 Sep;116(9):1386-90.
To compare the efficacy and safety of remifentanil and fentanyl in patients undergoing a modified radical mastectomy or total hysterectomy.
Fifty-four patients were evenly randomised into remifentanil group and fentanyl group. Anesthesia was induced by propofol (1 - 2 mg/kg) and either remifentanil (2 microg/kg) or fentanyl (2.5 microg/kg), and was maintained with inhalation of nitrous oxide in oxygen (2:1) and continuous infusion of either remifentanil (0.2 microg.kg(-1).min(-1)) or fentanyl (0.03 microg.kg(-1).min(-1)).
The number of patients exhibiting light anesthesia responses in the remifentanil group during intubation and the maintenance of anesthesia was significantly less than that in the fentanyl group. Both systolic and diastolic blood pressures in the fentanyl group were significantly higher than those in the remifentanil group during intubation, skin incision, maintenance of anesthesia and extubation. The time to opening eyes on command and the time for extubation after surgery was comparable between the two groups. More patients in the remifentanil group (25 patients) required bolus injection of morphine for postoperative pain relief than those in the fentanyl group (5 patients, P < 0.05). There was no significant difference between the two groups in terms of side effects.
Under the condition of this study protocol, the anesthetic and analgesic effects of remifentanil are more potent than those of fentanyl. Remifentanil can offer superior intraoperative hemodynamic stability in comparison with fentanyl, and has no compromising recovery from anesthesia.
比较瑞芬太尼和芬太尼在接受改良根治性乳房切除术或全子宫切除术患者中的疗效和安全性。
54例患者被均匀随机分为瑞芬太尼组和芬太尼组。采用丙泊酚（1 - 2mg/kg）联合瑞芬太尼（2μg/kg）或芬太尼（2.5μg/kg）诱导麻醉，并通过吸入氧化亚氮和氧气（2:1）以及持续输注瑞芬太尼（0.2μg·kg⁻¹·min⁻¹）或芬太尼（0.03μg·kg⁻¹·min⁻¹）维持麻醉。
瑞芬太尼组在插管和麻醉维持期间出现浅麻醉反应的患者数量显著少于芬太尼组。芬太尼组在插管、皮肤切口、麻醉维持和拔管期间的收缩压和舒张压均显著高于瑞芬太尼组。两组术后指令睁眼时间和拔管时间相当。瑞芬太尼组（25例患者）比芬太尼组（5例患者，P < 0.05）需要更多患者静脉推注吗啡以缓解术后疼痛。两组在副作用方面无显著差异。
在本研究方案条件下，瑞芬太尼的麻醉和镇痛效果比芬太尼更强。与芬太尼相比，瑞芬太尼可提供更好的术中血流动力学稳定性，且不影响麻醉恢复。
