妇科腹腔镜手术七氟醚与丙泊酚麻醉恢复期的比较

Comparison between Sevoflurane and Propofol recovery from anesthesia in gynecological laparoscopical surgery

目的:比较妇科腹腔镜术中七氟醚-瑞芬太尼静吸复合麻醉与丙泊酚-瑞芬太尼静脉复合麻醉的恢复情况。方法:将ASAⅠ～Ⅱ级择期行腹腔镜妇科手术的患者50例,随机分为七氟醚-瑞芬太尼静吸复合麻醉组(M组)和丙泊酚-瑞芬太尼静脉复合麻醉组(N组),每组25例。分别记录、对比分析两组麻醉效果。结果:M组术后不良反应事件中恶心发生率为36%(9/25),与N组8%(2/25)比较差异有统计学意义(χ2=4.20,P<0.05),七氟醚-瑞芬太尼静吸复合麻醉组恶心发生率高于丙泊酚-瑞芬太尼静脉复合麻醉组。自主呼吸恢复时间,M组为(6.30±0.80)min,N组为(7.90±0.86)min,t=-6.79,P<0.01;睁眼时间,M组为(7.40±0.87)min,N组为(9.20±1.00)min,t=-6.64,P<0.01;拔管时间,M组为(9.30±0.84)min,N组为(10.90±0.88)min,t=-6.56,P<0.01;定向力恢复时间,M组为(10.80±1.21)min,N组为(12.60±1.50)min,t=-4.45,P<0.01,故M组与N组在自主呼吸恢复时间、睁眼时间、拔管时间、定向力恢复时间等方面比较差异有统计学意义,七氟醚-瑞芬太尼复合麻醉有显著优势。结论:七氟醚-瑞芬太尼复合麻醉在妇科腹腔镜手术麻醉中可以提供较满意的麻醉效果,术后苏醒快,恢复质量高,是较为理想的麻醉方法。

Objective：To compare recovery in the gynecological laparoscopic surgery with Sevoflurane-inhalation anesthesia with Remifentanil and Propofol-Remifentanil intravenous anesthesia.Methods：ASA Ⅰ-Ⅱ class scheduled for laparoscopic gynecologic surgery,50 cases were randomly divided into Sevoflurane-Remifentanil inhalation anesthesia group（M group） and Propofol-Remifentanil intravenous anesthesia group（N group） in 25 cases.Anesthesia effect of two groups were recorded and compared.Results：The incidence of nausea in adverse events in M group of 36% compared with 8% in N group was significant（χ2=4.20,P0.05）,the incidence of nausea of M group was higher than that of N group.Recovery time of spontaneous breathing,M group was（6.30±0.80） min,N group with（7.90±0.86） min,t=-6.79,P0.01;eye opening,M group was（7.40±0.87） min,N group with（9.20±1.00） min,t=-6.64,P0.01,extubation time：M group was（9.30±0.84） min,N group with（10.90±0.88） min,t=-6.56,P0.01;recovery time of orientation：M group was（10.80±1.21） min,N group with（12.60±1.50） min,t=-4.45,P0.01;Therefore,in the M group and N group recovery time of spontaneous breathing,eye opening,tracheal extubation,orientation and other aspects of the recovery time was statistically significant,Sevoflurane-Remifentanil anesthesia had significant advantages.Conclusion：Sevoflurane-Remifentanil anesthesia in gynecological laparoscopic surgery may provide satisfactory anesthesia,rapid recovery after surgery,recovery of high quality,is an ideal method of anesthesia.