目的:探讨脊柱手术中应用瑞芬太尼控制性降低血压以提高手术安全性的临床效果.方法:选取2009年1～12月在我院进行全麻脊柱手术治疗的60例患者,ASA分类为Ⅰ～Ⅱ级,患者心、肺、肝、肾功能均正常,无内分泌系统疾病,无高血压病史.将所有患者随机分为两组,各30例,观察组以瑞芬太尼作为术中控制性降压药物.结果:观察组手术开始后各个观察时间点收缩压显著性下降,与对照组同时间的收缩压相比具有统计学意义(P<0.01).观察组在手术开始后30 min、45 min心率显著减缓,与麻醉前相比差异具有统计学意义(P<0.05).结论:本次研究中,脊柱手术的麻醉应用瑞芬太尼能够起到加强麻醉效果的作用,可以控制血压、心率,减少术中出血量,提高术中术野清晰度.%Objective: To investigate the clinical effect of applying remifentanil controlled blood decompression in spinal surgery for improving the surgical safety. Methods: 60 patients were selected who were accepted spinal anesthesia surgery treatment from January to December 2009 in our hospital, ASA was classified into grade Ⅰ - Ⅱ , and cardiopulmonary, liver and kidney functions of the patients were normal with no endocrine system disease and hypertension history. They were randomly divided into two groups, and Lhe observation group took remifentanil as intraoperative hypotension drug. Results:The systolic blood pressure of each observation time point of the patients in the observation group after the beginning of surgery was decreased significantly, and had statistical significance compared with the systolic blood pressure of the control group at the same time (P＜0.01). The heart rate of the patients in the observation group was significantly slowed in 30 min and 45 min after the starting of the surgery, the difference had statistical significance compared with the anesthesia (P＜0.05). Conclusion: Spinal surgery anesthesia with remifentanil can play a role of strengthening anesthesia, control blood pressure and heart rate, reduce intraoperative blood loss, and improve the intraoperative visual field clarity in this study.
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