瑞芬太尼-异丙酚全凭静脉麻醉用于腹腔镜胆囊切除术的体会

Experience of Remifentanil Combined with Propofol Total Intravenous Anesthesia in Laparoscopic Cholecystectomy

目的分析瑞芬太尼复合异丙酚全凭静脉麻醉在腹腔镜胆囊切除术的应用及临床疗效。方法将我院80例择期行LC手术的患者随机分为静吸组及静脉组,静吸组采用静吸复合麻醉,静脉组采用全凭静脉麻醉。结果两组手术时间、睁眼时间、拔管时间比较,差异无统计学意义(P>0.05),拔管5min OAAS评分和术后恶心呕吐例数比较,差异有统计学意义(P<0.05);两组在气腹后10min的HR、SBP、DBP及术毕HR比较,静吸组明显高于其诱导前基础值,差异有统计学意义(P<0.05),静脉组无明显变化;气腹后10min、气腹结束及手术毕,静吸组的HR均明显高于静脉组,差异有统计学意义(P<0.05)。结论瑞芬太尼-异丙酚全凭静脉麻醉用于LC,可控性强,术中血液动力学稳定,术后苏醒迅速彻底,各种不良反应和副作用轻,减轻了患者的痛苦,是一种安全、有效的快通道麻醉方法。

Objective To analyse the clinical efficacy of remifentanil combined with propofol total intravenous anesthesia in laparoscopic cholecystectomy. Methods 80 cases of LC patients were randomly divided into aspiration group and intravenous group,aspiration group patients used aspiration anesthesia,intravenous group patients used intravenous anesthesia. Results There was no significant difference between two group＇s surgery time, eyes open time, decannulation time （P 〈 0.05 ） ; tube out 5min OAAS score and postoperative nausea and vomiting several cases compared, there was a significant difference（P 〈 0.05）;two group＇s pneumoperitoneum after 10min of HR, SBP, DBP and HR after surgery compared, aspiration groups was significantly higher than its pre-induction value basis,there was a significant difference（P 〈 0.05 ）, intravenous group were no significant changes;pneumoperitoneum after 10min,the end of the pneumoperitoneum and after surgery,aspiration group＇ s HR were significantly higher than intravenous group, there was a significant difference （P 〈 0.05）. Conclusion Remifentanil combined with propofol total intravenous anesthesia in laparoscopic cholecystectomy, strong control, surgery hemodynamic stability, regained consciousness quickly and completely after the operation, a variety of adverse reactions and side effects light, can alleviate the suffering of the patients, is a safe, effective method of fast-track anesthesia.