丙泊酚或七氟烷复合瑞芬太尼麻醉对妇科腹腔镜手术病人麻醉苏醒的影响

Effect of Propofol/Remifentanil and Sevoflurane/Remifentanil Anesthesia on the Emergence in Patients Undergoing Gynecological Laparoscopy

目的:比较丙泊酚或七氟烷复合瑞芬太尼用于妇科腹腔镜手术后麻醉复苏质量。方法:选择ASAⅠ级,拟于气管内插管全身麻醉下行腹腔镜子宫肌瘤剔除术的患者30例,随机分为七氟烷组(S组)和异丙酚组(P组),每组15例。麻醉诱导采用丙泊酚,芬太尼,爱可松。完成气管播管后,S组吸入七氟烷维持麻醉,P组静脉持续输注丙泊酚(4～6)mg/kg·h维持麻醉。两组均同时复合瑞芬太尼连续输注,根据血流动力学变化调整瑞芬太尼给药速度,维持循环稳定。观察各时点血流动力学参数,苏醒时间,肌力等级,疼痛评分,躁动评分并记录。结果:P组在手术开始时血压低于S组(P<0.05),其它各时点血流动力学指标以及苏醒时间、肌力、疼痛评分和躁动评分两组间无显著性差异(P>0.05)。结论:丙泊酚或七氟烷复合瑞芬太尼用于妇科腹腔镜手术后苏醒迅速,躁动发生率低。

Objective compare me emergence properties of propofol /remifentanil with sevoflurane/remifentanil anesthesia in patients undergoing gynecological laparoscopy.Methods：Thirty ASA classⅠfemale patients with bysteromyoma were randomly allocated to two groups with 15 cases each.Anesthesia was maintained with sevoflurane after anesthesia induction with propofol,fentanyl,and rocuromum in group S,and maintained with propofol infusion in group P.At the end of operation,all anesthetics were discontinued and the time of opening eyes,muscle force scores,pain scores and agitation scores were also analyzed.Results：BP at the beginning of skin incision was significantly lower in group P than group S（P0.05）.Other parameters were not significantly different between groups（P0.05）. Conclusion：Propofol/remifentanil and sevoflurane/remifentanil both provide satisfactory anesthesia for gynecological laparoscopy,and the effects are similar between these two techniques.