瑞芬太尼在腹腔镜胆囊切除术患者中的应用研究

Remifentanil Study in the Application of the Patients Undergoing Laparoscopic Cholecystectomy

目的探讨瑞芬太尼在腹腔镜胆囊切除术患者麻醉中的临床效果及安全性。方法将80例腹腔镜胆囊手术患者采用随机数字的方法分为观察组和对照组各40例。两组患者麻醉诱导和麻醉方法相同,观察组给予持续静脉泵入瑞芬太尼,对照组持续静脉泵入芬太尼,观察两组患者血流动力学变化、麻醉时间、术后苏醒情况、拔管后疼痛程度及不良反应等。结果两组患者诱导期血压变化差异无统计学意义(P>0.05),但观察组患者心率下降较对照组明显(P<0.05);两组患者麻醉时间相似(P>0.05),但是观察组患者术后睁眼时间、呼吸恢复时间、问答切题时间和拔管时间均短于对照组(P<0.05);观察组患者拔管后即刻和拔管后30min,伤口疼痛程度VAS评分低于对照组(P<0.05),而拔管后24h两组VAS评分相似(P>0.05);观察组患者无恶心、呕吐等发生,对照组有8例,二者差异有统计学意义(P<0.05)。结论瑞芬太尼应用于腹腔镜胆囊切除术,患者围术期麻醉更平稳、可控性强、苏醒迅速、副作用小、安全有效,值得临床推广应用。

Objective To.investigate the remifentanil anesthesia in patients with laparoscopic cholecystectomy in the clinical efficacy and safety. Methods 80 patients undergoing laparoscopic cholecystectomy were randomly divided into two groups of methods and the control group 40 cases. Induction of anesthesia and anesthesia groups were the same way, observe the group was given continuous intravenous infusion Ru Ruifen too Nepalese control group, continuous intravenous infusion of fentanyl, hemodynamic changes were observed in patients, duration of anesthesia, postoperative recovery situation, pull tube pain and adverse reactions. Results The patients were induced blood pressure changes were not significantly different（P〉 0.05）, but the observation group than in the control group in patients with heart rate decreased significantly （P 〈0.05）; the two groups were similar anesthesia time （P〉 0.05）, but the observation group were After opening eyes, breathing recovery time, Q to the point of time and extubation time were shorter than the control group （P 〈0.05）; observed in patients immediately after extubation and extubation after 30min, wound pain VAS scores than the control group （P 〈0.05）, and 24h after extubation VAS score two similar （P〉 0.05）; observed in patients without nausea and vomiting Occurred in the control group, 8 cases, there was a significant difference between them（P 〈0.05）. Conclusion Remifentanil used in laparoscopic cholecystectomy, perioperative anesthesia is more stable, controllable, wake up quickly, side effects, safe and effective, worthy of clinical application.