异丙酚和七氟醚麻醉用于腹腔镜腹膜透析置管术患者苏醒质量研究

The effect of propofol and sevoflurane on the quality of patient recovery from anesthesia with laparoscopic placement of peritoneal dialysis catheter

目的探讨异丙酚和七氟醚麻醉对腹腔镜腹膜透析置管术患者麻醉后苏醒质量的影响。方法选择择期行腹腔镜腹膜透析置管术的终末期肾病患者100例,随机分成两组:异丙酚组(n=50),给予芬太尼、阿曲库铵、异丙酚行麻醉诱导,异丙酚、瑞芬太尼维持麻醉;七氟醚组(n=50):给予芬太尼、阿曲库铵、七氟醚行麻醉诱导,七氟醚维持麻醉。观察围手术期患者的血液动力学状态,术后麻醉恢复时间,疼痛、呕吐评分。结果两组患者在气管插管时,血压、心率均升高(P<0.05),七氟醚组较异丙酚组升高较低(P<0.05);七氟醚组麻醉后苏醒时间较异丙酚组快(P<0.05),两组疼痛、呕吐评分差异无显著性(P>0.05)。结论七氟醚用于腹腔镜腹膜透析置管术麻醉诱导和维持,具有血液动力学平稳,苏醒快速的优点。

[Objective] To observe the effects of propofol and sevoflurane on the quality of patient recovery from anesthesia with laparoscopic placement of peritoneal dialysis catheter.[Methods] One hundred patients with end-stage renal disease scheduled for elective laparoscopic placement of peritoneal dialysis catheter were randomly divided into two groups.The propofol group（n =50） were given fentanyl,atracurium,and propofol for tracheal intubation and given propofol and remifentanil for anesthesia maintenance.The sevoflurane group（n =50） were given fentanyl,atracurium,and sevoflurane for tracheal intubation and given sevoflurane for anesthesia maintenance.The hemodynamics during perioperative,the time to recovery from anesthesia,the pain and vomiting score were observed.[Results] The blood pressure and HR rised in both groups in intubation（P 0.05）,but it was more higher in the propofol group than in the sevolurane group（P 0.05）.The time to recovery from anesthesia was shorter in the sevoflurane group than that in the propofol group（P 0.05）.There were no significant difference between two groups on pain and vomiting score（P 0.05）.[Conclusions] Using sevoflurane for intubation and anesthesia maintenance can obtain more stable hemodynamics and soon recovery from anesthesia for the patients underwent laparoscopic placement of peritoneal dialysis catheter.