丙泊酚和瑞芬太尼全静脉麻醉与丙泊酚和异氟醚静吸复合麻醉在腹腔镜手术中的对比观察

Compare Propofol combined with Remifentanil total intravenous anaesthesia with Propofol combined with isoflurane infusion-intravenous undergoing laparoscopic operation

目的评价以丙泊酚和瑞芬太尼全静脉麻醉对腹腔镜手术患者的应激反应的影响。方法将100例ASAI-Ⅱ级的腹腔镜胆囊切除患者随机分成两组（丙泊酚、瑞芬太尼维持为A组，丙泊酚、异氟醚维持为B组），每组50例。分别记录两组麻醉前、气腹后即刻、气腹后20min和术毕的平均动脉压（MAP）、心率（HR）及末梢血糖（Glu）。结果气腹后即刻A组MAP、HR显著低于B组（P〈0．01）；末梢血糖在气腹后20min及术毕显著低于B组（P〈0．05）。结论以丙泊酚和瑞芬太尼的全静脉麻醉较之以丙泊酚、异氟醚的静吸复合麻醉用于腹腔镜手术能更有效地抑制术中二氧化碳气腹所致的应激反应。

Objective To evaluation the effects of immune status from Compare propofol combined with remifentanil total intravenous anaesthesia undergoing laparoscopic operation. Methods 100 ASA Ⅰ - Ⅱ patients undergoing cysticolithby laparoscopic were randomly allocated into 2 groups （n = 50） ;Group A： propofol com- bined with remifentanil total intravenous anaesthesia; Group B：propofol combined with isoflurane infusion-intravenous anaesthesia. MAP,HR and Blood Glue of before anaesthesia,pneumoperitoneum immediately,20 min after pneumoperitoneum and postoperative immediately for tow groups patients were recorded. Results MAP,HR at pneumoperitoneum immediately, group A was lowest than group B （P 〈 0. 01 ） ; Blood Glue at 20 rain after pneumoperitoneum and postoperative immediately, group A was lower than group B （ P 〈 0. 05 ）. Conclusion Propofol combined with remifentanil total intravenous anaesthesia can more effective to prevent the effects of immune status from CO2 pneumoperitoneum than propofol combined with isoflure infusion-intravenous.