瑞芬太尼丙泊酚与丙泊酚异氟醚全麻用于腹腔镜胆囊切除术的效果比较

目的比较瑞芬太尼丙泊酚全凭静脉麻醉与丙泊酚异氟醚静吸复合麻醉用于腹腔镜胆囊切除术的麻醉效果。方法 60例腹腔镜胆囊切除术患者随机分为对照组(丙泊酚异氟醚静吸复合麻醉)和观察组(瑞芬太尼丙泊酚全凭静脉麻醉),每组30例,对比两组进入手术室(T0)、气腹前(T1)、气腹后5min(T2)和手术结束(T3)血流动力学指标变化、拔管时的清醒程度及术后随访结果。结果对照组的SBP、DBP在T2时均明显比T0时高,HR在T2、T3均明显高于T0时,差异有统计学意义(P<0.05);T2时对照组的DBP高于观察组,差异具有统计学意义(P<0.05);T2及T3对照组明显患者的SBP、HR高于观察组(P<0.05);观察组明显拔管后5minOAAS评分高于对照组,差异具有统计学意义(P<0.05);观察组术后恶心、呕吐发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论瑞芬太尼丙泊酚全凭静脉麻醉应用于腹腔镜胆囊切除术,麻醉效果良好,术中患者血压及心率稳定且可抑制术中应激反应的发生,术后苏醒快,并发症较少。

Objective To investigate effect comparison of the remifentanil propofol total intravenous anesthesia with propofol and isoflurane anesthesia for laparoscopic cholecystectomy anesthesia. Methods 60 cases of laparoscopic cholecystectomy patients were randomly divided into control group and observation group, 30 cases in each group.The hemodynamic indexes of each time point, the OAAS score after extubation and the postoperative follow-up results were compared. Results In the control group, SBP, DBP at T2 were significantly higher than T0, HR at T2, T3 were significantly higher than T0, the difference was significant （P〈0.05 ）; T2 DBP of the control group at T2 was higher than that of the observation group, the difference was significant （P〈0.05 ）; at T2 and T3, two groups of patients with SBP, HR comparison, the control group was significantly higher than that of the observation group （P〈0.05 ）, the difference was statistical significant; the two groups of patients in after extubation 5min OAAS score comparison, the observation group was higher than that in the control group, the difference had statistical significance （P〈0.05 ）; two groups in postoperative vomiting and nausea comparison, the observation group was better than control group, the difference had statistical significance （P〈0.05 ）. Conclusion Remifentanil propofol total intravenous anesthesia used in laparoscopic cholecystectomy has good anesthesia effect, intraoperative blood pressure and heart rate stability and can restrain the occurrence of stress response, postoperative recovery quickly, less complication.