靶控输注异丙酚与吸入异氟醚麻醉在腹腔镜胆囊切除术中的效果

COMPARISION OF ANESTHESIA MAINTAINED BY PROPOFOL TARGET-CONTROLLED AND INFUSION BY ISOFLURANE INHALATION IN LAPAROSCOPIC CHOLECYSTECTOMY

目的比较靶控输注异丙酚(target-controllde infusion,TCI)全凭静脉麻醉和异氟醚吸入麻醉二种不同方式在腹腔镜胆囊切除术(Iaparoscopic cholecystectomy,LC)应用中的临床效果.方法将30例择期行LC手术的患者随机分为二组.TCI组(T组)(n=15):设定诱导时靶浓度为4μg/ml,术中维持异丙酚靶浓度为3.0～3.5μg/ml.异氟醚组(Ⅰ组)(n=15):采用3%异氟醚吸入诱导、1%～25%维持.术中监测心率(heart rate,HR)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、平均动脉压(meam arterial pressure,MAP)等指标.结果 T组诱导时间与Ⅰ组比较差异有统计学意义(P＜0.05),术中T组生命体征维持相对平稳,术后苏醒T组明显优于Ⅰ组.结论 TCI全凭静脉麻醉方法用于LC术,术中血流动力学稳定,术后患者苏醒迅速,明显优于异氟醚吸入麻醉方法.

Objective To study the advantage of propofol by target- controlled infusion（TCI） for laparoscoplc cholecystectomy（LC） in comparison with isoflurane inhalation. Methods 30 patients scheduled for LC were randomized into two groups： Propofol group（T-group） and Isoflurane group（I- group）. Propofol group （T-group） （1/ = 15）, whom in which were given TCI by the target concentration 4/~g/ml during induction and （3-3.5）μg/ml during maintenance. 3% isoflurane during induction and 1% - 2.5% during maintenance were inhaled in I - group. SBP, DBP and HR were monitored continu- ously in two groups during operation. Results The time of induction in T- group was shorter than that in I - group（P〈0.05）. The vital signs were stable in T- group during operation and the patients in T- group gained more comfortable recov- ery than those in I - group. Conclusion During the anesthesia of propofol TCI for LC, the hemodynamics is more stable than that of isoflurane inhalation, and the recovery is better. Therefore sothe anesthesia maintained by propofol target controlled infusion for laparoscopic cholecystectomy is better than that by isoflurane inhalation.