芬太尼与瑞芬太尼在妇科腹腔镜手术全麻诱导插管期效果比较分析

The Comparative Analysis of the Effectiveness of Fentanyl and Remifentanil in Gynaecological Laparoscopic Operation under Systemic Anesthesia Induction during Intubation

目的:探讨分析芬太尼与瑞芬太尼在妇科腹腔镜手术全麻诱导插管期的临床效果。方法:随机选择2009年8月～2010年8月间,在我院接受妇科腹腔镜手术的100例患者作为研究对象,随机分为2组(芬太尼组、瑞芬太尼组),全麻诱导期分别给予芬太尼与瑞芬太尼。结果:瑞芬太尼组和芬太尼组患者组内HR、SBP及DBP诱导及插管后与麻醉前比较,插管后与诱导后比较,差异均具有绕计学意义(P<0.05)。瑞芬太尼组患者插管后和气腹后的HR、SBP及DBP均明显低于芬太尼组(P<0.05);瑞芬太尼组诱导时不良反应明显减少。结论:瑞芬太尼能有效抑制气管插管所引起的应激反应,及人工气腹所引起的血流动力学变化,在妇科腹腔镜患者手术中应用安全、有效,不良反应发生率低,值得在临床推广使用。

Objective：To explore the clinical effectiveness of fentanyl and remifentanil in gynaecological laparoscopic operation under systemic anesthesia induction during intubation.Methods：100 cases conducted gynaecological laparoscopic operation from April 2009 to April 2010 were randomly selected as the subjects and allocated into two groups including fentanyl group and remifentanil group. These patients received fentanyl or remifentanil during systemic anesthesia induction.Results：There were significant differences for HR, SBP and DBP induction in inner-group（remifentanil group and fentanyl group） comparison（P0.05）.Besides,there also were statistical significances（P0.05） for post-intubation and preanesthcsia,and post-intubation and post-induction in inner-group（remifentanil group and fentanyl group） comparison.Adverse effects decreased obviously under remifentanil induction.Conclusions：Remifentanil that can inhibit stress reaction induced by tracheal intubation effectively and hemodynamic changes induced by artificial pneumoperitoneum is a safe and effective drug with low incidence of adverse effects in gynaecological laparoscopic operation and has potential extensive application in clinical practice.