瑞芬太尼联合异丙酚或依托咪酯全麻对腹腔镜妇科手术后恶心呕吐的影响

Effect of remifentanil-propofol and remifentanil-etomidate general anesthesia on postoperative nausea and vomiting in gynecologic laparoscopy

目的:观察瑞芬太尼联合异丙酚或依托咪酯全麻对腹腔镜妇科手术后恶心呕吐的影响。方法:择期全麻下行腹腔镜妇科手术病人80例,ASA分级I～Ⅱ级,心肺功能正常。随机分成瑞芬太尼-异丙酚组(RP组)和瑞芬太尼-依托咪酯组(RE组)各40例。两组全麻诱导用药相同,维持麻醉RP组采用瑞芬太尼联合异丙酚,RE组采用瑞芬太尼联合依托咪酯。术后24h内观察并评估术后恶心呕吐(PONV)发生率及程度;记录需要昂丹司酮止吐治疗的病人例数。结果:RP组术后PONV发生率为20.0%,RE组为37.5%,两组比较差异有统计学意义(P<0.05)。结论:气管内插管全麻行腹腔镜妇科手术时,瑞芬太尼联合异丙酚能降低PONV的发生率。

Objective：To investigate the effect of remifentanil-pmpofol and remifentanil-etomidate general anesthesia on postoperative nausea and vomiting （PONV） in the patients undergoing gynecologic laparoscopy.Methods：Eighty patients undergoing elective gynecologic lapamscopy with general anesthesia were divided randomly into two groups：group RP and group RE. Following induction with midazolam, propofol, remifentanil and vecuronium, anaesthesia was maintained with remifentanil-propofol in group RP or remifentanil-etomidate in group RE.The frequency of PONV within the first 24 h postoperation was evaluated.The number of the patients, who received ondansetron for PONV, was also recorded.Results：The incidences of PONV were 20% in group RP and 37.5% in group RE.The incidence of PONV was significantly lower in the RP group compared to the RE group （P〈0.05）. Conclusion：In gynecologic laparoscopy, remifentanil-propofol anesthesia can prevent PONV efficiently.