瑞芬太尼静吸复合麻醉在腹腔镜胆囊切除术中的应用

Application of Remifentanil and inhalation anesthesia in laparoscopic cholecystectomy

目的探讨瑞芬太尼静吸复合麻醉在腹腔镜胆囊切除术中的效果。方法依据麻醉方法、药物的不同随机分为瑞芬太尼组(R组)和芬太尼组(F组)。两组术前30min常规肌内注射0.1g苯巴比妥钠和0.5mg阿托品,全身麻醉均采用经口气管内插管。F组用3μg/kg芬太尼、1mg/kg丙泊酚、0.04mg/kg咪唑安定、维库溴铵0.1mg/kg诱导插管。结果瑞芬太尼组苏醒时间均明显优于芬太尼组(P<0.05);瑞芬太尼组切皮和插管后的DBP、HR及SBP均明显低于芬太尼组(P<0.05)。瑞芬太尼组和芬太尼组比较诱导后与插管后;麻醉前与组内DBP、HR及SBP诱导后比较;具有明显差异(P<0.05)。结论瑞芬太尼用于维持与全麻诱导,是有效、安全的,能够提供更快的麻醉恢复时间及更平稳的血液动力学。

Objective To investigate effect of remifentanil inhalation anesthesia in laparoscopic cholecystectomy.Methods The methods of anesthesia,drugs were randomly divided into remifentanil group（R group） and the fentanyl group（F）.Both groups 30 min before the conventional intramuscular injection of phenobarbital sodium and 0.1g 0.5mg atropine,general anesthesia are used orotracheal intubation.Group F with 3μg/kg fentanyl,1mg/kg propofol,0.04mg/kg midazolam,vecuronium 0.1mg/kg intubation.Results The recovery time remifentanil group were significantly better than the fentanyl group（P0.05）;remifentanil group after intubation,skin incision and DBP,HR and SBP were significantly lower than the fentanyl group（P0.05）.Remifentanil group and fentanyl group compared with the intubation after induction;anesthesia group before and DBP,HR and SBP compared after induction;a significant difference（P0.05）.Conclusions Remifentanil for induction of anesthesia was maintained with effective and safe.Remifentanil and propofol cnesthesia for lopavoscopic gallbladder surgery anesthesia can provide faster recovery time and more stable hemodynamics.