腹腔镜手术的不同麻醉方法对术后恢复的影响

Effects of different anesthesia methods on postoperative recovery in patients undergoing laparoscopy

目的研究不同麻醉方法用于腹腔镜手术患者术后拔除气管导管时对拔管时间及改良OAA/S评分的影响。方法选择行腹腔镜手术的患者40例。将40例患者单纯随机分为T、Ⅰ两组,每组20例。T组:采用静脉输注工作站靶控输注异丙酚和瑞芬太尼;Ⅰ组为静吸复合组。术毕观察自主呼吸恢复时间、睁眼时间、拔管时间、OAA/S评分>5分时间,发生呕吐、烦躁人数。结果发生呕吐、烦躁者人数Ⅰ组明显多于T组,有非常显著性差异(P<0.01),自主呼吸恢复时间、睁眼时间、拔管时间、OAA/S评分>5分时间I组明显长于T组(P<0.01,P<0.05)。结论TCI靶控输注异丙酚复合瑞芬太尼用于腹腔镜手术的麻醉可减少术后恢复时的并发症。

Objective To sutdy the effect of different anesthesia methods on the time of tracheal extubation and the scoring of OAA/S in patients undergoing laparoscopy. Methods Forty ASAI ～ Ⅱ patients undergoing laparescopy were randomly divided into 2 groups with 20 patients in each group（ T and Ⅰ）. Anesthesia in T group was maintained with target-controlled infusion （TCI） of propofol and remifentanil. Anesthesia in I group was maintained with isoflurane inhalant, intermittent boluses of vecuronium and remifentanil continuous infusion. Automatic respiratory recovery time, eyes open time, trachea cannula extubated time and the OAA/S score of 5 degree time were recorded. Results Patients with dyspboria and vomiting in group Ⅰ were more than in group T. （P 〈 0.01 ）. Automatic respiratory recovery time, eyes open time, trachea eannula extubated time and the OAA/S score of 5 degree time in group Ⅰ was longer than that in group T（ P 〈0.01 ,P 〈0.05） ,respectively. Conclusion TCI propofol and remifentanil has advantage of less complication during postoperative recovery.