瑞芬太尼联合异丙酚全麻与吸入异氟醚麻醉在腹腔镜胆囊切除术中的比较

Comparision of Haemodynamic Between Remifentanil/propofol and Isoflurane for Laparoscopic Cholecystectomy

目的 比较瑞芬太尼-异丙酚全凭静脉麻醉和异氟醚麻醉在腹腔镜胆囊切除术（LC）中血流动力学的变化、术后恢复及恶心、呕吐的发生率。方法 择期全麻下行LC手术病人30例，美国麻醉医师协会（ASA）分级Ⅰ～Ⅱ级，心肺功能正常，随机分成R组（瑞芬太尼-异丙酚麻醉组）和Ⅰ组（异氟醚麻醉组），各15例。记录基础值、麻醉诱导后、插管后1min、5min和气腹时、气腹后5min，拔管时的动脉收缩压（SBP）、舒张压（DBP）、心率（Ha）和拔管时间、清醒程度及术后恶心、呕吐的情况。结果 术中R组生命体征维持相对平稳，术后苏醒R组明显优于Ⅰ组，且术后发生恶心、呕吐的病人数R组明显减少（P〈0．05）。结论 瑞芬太尼-异丙酚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，且术后恶心、呕吐的发生率明显降低，明显优于异氟醚吸入麻醉方法。

Objective To compare haemodynamics between remifentanil/propofol and isaflurane in patients undergoing laparoscopic cholecystectomy（LC） .Methods Thirty patients undergoing selected LC, American Society of Anesthesiologists（ASA） grade Ⅰ-Ⅱ ,with normal cardiac and lung function. Were randomly divided into 2 groups of 15 patients each group R and group Ⅰ. The systolic blood pressure （SBP） ,diastolic blood pressure （DBP） and heart rate （HR） were recorded at the time of baseline, after induction, 1 min and 5 rain after intuition, CO2 insufflation, 5 min after insufflation, extubation. The time of ectubation and orientation were recorded. Postoperative nausea and vomiting （PONV） were observed. Results The vital signs were stable in R group during operation and the patients in R group gained more comfortable recovery than those in Ⅰ group and patients with PONV in group R was significantly less than that in group Ⅰ （ P 〈 0.05） .Conclusion Combinational infusions of remifentanil and propofol during laparoscopic cholecystectomy, the hemodynamics is more stable than that of isoflurane inhalation, and the recovery is better.Patients with PONV in group R was significantly less than that in group Ⅰ.