摘要
目的探讨异丙酚全凭静脉麻醉应用于腹腔镜手术的效果，寻求临床安全有效的方法。方法择期全麻手术患者60例，随机分成两组，对照组（组Ⅰ，n=30），观察组（组Ⅱ，n=30）。诱导插管后，麻醉维持：组Ⅱ，以异丙酚1mg／kg静脉注射，同时用美国百特Baxter AS40A型微量泵持续静注异丙酚10mg／kg／hr，10min，以后8mg／kg／hr，10min后6mg／kg／hr。组Ⅰ，以静吸复合麻醉，异氟醚1-1．5MAC，两组均间断静注芬太尼2μg／kg／hr、雏库溴铵0．1mg／kg／hr，两组至术毕停药。比较麻醉效果，诱导前、气腹后5、10、15min、气腹毕、术毕的SBP、DBP、HR、SpO2、拔管时间、清醒程度及不良反应，以统计学分析结果。结果组Ⅰ在气腹后5、10、15min的HR、SBP、DBP及术毕HR高于诱导前的基础值，有显著性差异（P〈0．05）。组Ⅱ气腹后10min、气腹毕、术毕的HR低于组Ⅰ，有显著性差异（P〈0．05）。组Ⅱ的术后恶心呕吐发生率低于组Ⅰ，有显著性差异（P〈0．05）。结论异丙酚全凭静脉麻醉应用于腹腔镜手术是临床安全有效的快通道麻醉方法。
Objectlve Inquiring into different third Propofol Quan Ping＇s of vein anaesthesia of applies effect in the peritoneoseope surgical operation, for seeking the method that clinical safety is effective. Method 60 casese general anesthesia surgical operation patients, and randomly divides into two groups, the compare group （ group Ⅰ , n = 30 ） , the observation group （ group Ⅱ , n = 30 ） . Guiding intubating afterwards , the anaesthesia is keeped ： Group Ⅱ , is with different third Propofol intravenous injection into 1mg/kg, and goes on after the Propofol 10mg/kg/hr, 10min, of different third of still notes 6mg/kg/hr behind the 8mg/kg/hr, 10min with American hundred special Baxter＇s AS4OA＇s mould drop pumps at the same time. Group Ⅰ and inhaling compound anaesthesia with still, different two Group of ether 1 - 1.5MAC, in the Isofluorane all is disconnected the still notes sweet smells , and too Fentanyl 2 μg/kg/hr and dimension warehouse bromine ammonium Vecuronium 0.1 mg/kg/hr, two group fully stop the medicine to the art. The SBP, DBP, HR and SpO2 that gentle stomach offspring＇s 5 ,10,15min and pneumoperitoneum Bi Shu finishes before the comparison anaesthesia effect is guided precedingly and the pneumoperitoneum and stirs mangages a time and regaining consciousness level and bad reaction, with the statistics analyses result. Result HR, SBP, DBP and the art of group 5,10,15min of Ⅰ hehind the pneumoperitoneum finish the foundation value （ P 〈 0. 05 ） that HR is more than before guiding , and have significance difference. The HR that lOmin and pneumoperitoneum Bi Shu finishes behind group Ⅱ＇s pneumoperitoneum is lower than team Ⅰ （ P 〈 0.05 ） and has significance difference. Nauseating to vomit the occurring rate after the group art of Ⅱ is lower than group Ⅰ （ P 〈0.05 ） and has significance difference. Conclusion Different third Propofol Quan Ping＇s vein anaesthesia application is the quick channel anaesthesia method that clinical safety is effective in the peritoneoseope surgical operation.
