异丙芬复合瑞芬太尼在高血压病人腹腔镜胆囊切除术中的临床应用

CLINICAL APPLICATION OF PROPOFOL AND REMIFENTANIL IN LAPAROSCOPIC CHOLECYSTECTOMY OF PATIENTS WITH HYPERTENSION

目的:探讨异丙芬和瑞芬太尼全凭静脉麻醉在高血压病人腹腔镜胆囊切除术的临床应用。方法:30例ASAⅡ级择期行腹腔镜胆囊切除术的高血压病人全部采用异丙芬、瑞芬太尼、维库溴铵全凭静脉麻醉(TIVA)。记录麻醉前、诱导后、插管时、气腹前、气腹后10min及术毕时病人的SBP、DBP、HR、SPO2以及麻醉恢复和麻醉并发症发生情况。结果:30例患者诱导后有明显的血压下降与心率减慢,较麻醉前有显著改变(P<0.05),麻醉维持过程中DBP、SBP、HR、SPO2无显著变化,术后苏醒快,恶心、呕吐发生率低。结论:异丙酚复合瑞芬太尼全凭静脉麻醉对腹腔镜行胆囊切除术的高血压病人血流动力学影响小,术中平稳,术后苏醒快,并发症少。

Objective：To study the clinical application of propofol and remifentanil in patients with hypertension undergoing laparoscopic cholecystectomy （LC） .Methods：Thirty patients with hypertension , ASA physical status Ⅱ, scheduled for LC ,were anesthetized with propofol,remifentanil and vecuronium . SBP,DBP, HR,and SPO2 before anesthesia,after induction,during tracheal intubation,10 minutes before and after pneumoperitoneum of CO2 and after operation were recorded.Results：DBP,SBP,and HR declined more significiantly after induction than those before anesthesia （P〈0.05） and there were no differences during anesthesia maintenance. The patients recovered quickly and the incidence of complications were low. Conclusion ：TIVA with propofol and remifentanil could get a stable homodynamics, rapid recovery and lower incidence of relevant complications in patients with hypertension undergoing LC.