瑞芬太尼丙泊酚靶控静脉麻醉用于妇科腹腔镜手术的效果评价

Evaluation of target controlled infusion remifentanil and propofol on gynecologic laparoscopy operation

目的评价瑞芬太尼和丙泊酚全静脉麻醉用于妇科腹腔镜手术的诱导、维持和术后苏醒过程。方法ASAⅠ～Ⅱ级妇科腹腔镜手术患者60例,分为瑞芬太尼丙泊酚血浆靶控输注组(TCI组)和静吸复合全麻组(G组),每组30例,记录两组各时段平均动脉压(MVP)、心率(HR)及术毕患者苏醒过程中各时段所需时间,观察患者拨管后各时段的意识状况、术后并发症及满意度。结果TCI组各时段血流动力学较G组平稳;在苏醒过程中,自主呼吸、睁眼、拔管、定向力恢复及离开恢复室时间TCI组明显短于G组;术后各时段意识恢复程度(OAA/S)评分TCI组明显高于G组(P<0.05)。两组均无术中知晓。结论瑞芬太尼复合丙泊酚靶控全静脉麻醉用于妇科腹腔镜手术,苏醒迅速,清醒质量高,术中血流动力学稳定,优于常规的静吸复合全麻。

Objective The purpose of this study is to evaluate the clinical efficacy of remifentanil combined with propofol in the course of anesthesia induction and analepsia. Methods 60 ASAⅠ～Ⅱpatients undergoing gynecologic laparoscopy were randomly divided into two groups：TCI group （total intravenous anesthesia,n = 30） and G group （intravenous combined inhalation anesthesia,n = 30）. Mean arterial pressure（MAP） and heart rate（HR） were observed at the time of anesthesia induction,tracheal intubation,the time of spontaneously breathing,awakeness,and post extubation were recorded; we observed the patient of conscious state,post-operative complications and the degree of patients＇ satisfaction. Results The hemodynamics of TCI group was more stable than that of G group. During the process of awakeness,the time of spontaneously breathing,awakeness and extubation,restoration of orientation and departing PACU in TCI group were shorter than that in G group; the postoperation OAAS score in TCI group was higher than that in G group. Conclusions Awake qualily of intravenous anesthesia with Propofol and remifentanil was better than that with Intravenous Combined Inhalation Anesthesia undergoing gynaecologic laparoscopy.