瑞芬太尼和芬太尼用于腹腔镜手术效果的比较

A Comparison of the Efficacy of Remifentanil and Fentanyl during Laparoscopic Operation

目的观察瑞芬太尼用于腹腔镜手术血流动力学指标的变化，并与芬太尼疗效进行比较。方法55例患者随机分为A、B两组。快速诱导后经口插入气管导管，麻醉维持均为静脉持续泵注异丙酚4～12mg／（kg·h），A组采用0．2～0．6μg／（kg·min）瑞芬太尼静脉泵入。B组采用芬太尼0．2ms／kg静脉滴注。于麻醉前、插管即刻、插管后、气腹后、停药及睁眼时记录心排血量、心指数、收缩压、舒张压和心率等血流动力学指标值。结果瑞芬太尼组对心排血量、心指数、收缩压、舒张压和心率等血流动力学指标的影响均较芬太尼组轻（P〈0．05）。结论临床麻醉剂量的瑞芬太尼复合异丙酚对血流动力学指标的影响较轻，此麻醉方法更适合腹腔镜手术。

Objective To investigate the effect of remifentanil on cardiovascular system undergoing laparoscopic operation, and compare with fentanyl. Methods 55 ASA I or Ⅱ patients undergoing laparoscopic operation were randomly selected and derided into two groups：group A and group B. After rapid induction all patients were intubated with a tube. Anesthesia was maintained with continuous infusion of propofol 4 N 12 mg/（ kg · h）. In group A remifentanil 0.2 - 0.6 μg/（ kg ·min） was infused. In group B fentanil 2 μg/kg was administered intravenously. Hemodynamic variables including output, cardiac index,systolic blood pressure,diastolic blood pressure and heart rate were continuously measured throughout anesthesia. Results The influence of remifentanil on hcmodynamic status of all patients was little than that in hemodynamics （ P〈0.05 ）. Conclusion Application of remifentanil combined with propofol is feasible during laparoscopic operation.