瑞芬太尼复合七氟烷用于腹腔镜胆囊切除术的临床研究

Effects of Combined Reminfentanil and Seveflurance on Laparoscopic Cholecystomy

目的探讨瑞芬太尼复合七氟烷应用于腹腔镜胆囊切除术中的麻醉效果、不良反应及对麻醉苏醒的影响。方法Ⅰ～Ⅱ级,无合并症,拟行腹腔镜胆囊切除术的成年患者100例,随机分为瑞芬和对照组,各50例,两组术前用药,麻醉诱导用药及方法相同,观察组于诱导开始用微量泵连续静脉输入瑞芬太尼(20μg/mlNS),输注速率根据麻醉深度及生命体征变化调节,不采用单次注药。麻醉期间常规监测NIBP、ECG、HR、SpO2观察麻醉效果、苏醒时间,麻醉苏醒程度、不良反应。结果术中芬太尼用量、七氟烷吸入浓度,瑞芬组较对照组低,观察组麻醉清醒时间、拔管时间明显短于对照组(P<0.01),苏醒评分明显高于对照组(P<0.05),两组术中低血压及心动过缓的发生差异无统计学意义(P>0.05)。结论应用瑞芬太尼复合七氟烷能明显加快腹腔镜胆囊切除术病人全身麻醉后的苏醒,其药理特性符合快通道麻醉的求,安全有效。

Objective To investigate the effects of anaesthesia with combined reminfentanil and seveflurance on patients receiving laparoscopic cholecystomy. Method One hundreds adults ASA Ⅰ-Ⅱpatients undergoing laparoscopic cholecystomy were randomly divided into two groups （n=50）. Patients in reminfentanil group （R group） continuously received reminfentanil （50 μg/kg/min） by using a microinfusion pump and seveflurance by inhalation. Patients in the control group （C group） were administered intermittently with fentanyl and seveflurance by inhalation. Both R and C group patients received the same pre-medication and induction medicine. NIBP, ECG, HR, SpO2, recovery time, and the side effects were monitored. Result During the whole operation, the concentration of seveflurance in R group was significantly lower than the C group （P〈0.05）. The time of recovery and extubation in R group was significantly shorter than the C group （P〈0.01）. There is no significant difference in NIBP and HR in both groups（P〉0.05）. Conclusion Patients receiving combined reminfentanil and seveflurance treatment have a shorter recovery time, and this treatment method is safe in general anaesthesia.