丙泊酚联合瑞芬太尼靶控输注在腹腔镜宫外孕手术中的临床应用

Clinical application of propofol combined with remifentanil target controlled infusion on laparoscopy ectopic pregnancy

目的探讨丙泊酚联合瑞芬太尼靶控输注在腹腔镜宫外孕手术中的临床效果。方法回顾分析2010年1月～2013年3月我院腹腔镜行宫外孕手术患者120例,随机分为观察组和对照组,每组60例。观察组采用丙泊酚联合瑞芬太尼进行麻醉,对照组采用丙泊酚联合芬太尼进行麻醉。记录患者术中循环系统变化及术后相关情况。结果观察组麻醉后收缩压(SBP)、心率(HR)较麻醉前明显下降,差异有统计学意义(P<0.05);观察组在麻醉后、气腹后循环系统波动小于对照组,差异有统计学意义(P<0.05),观察组术后唤醒时间、苏醒延迟明显优于对照组,差异有统计学意义(P<0.05);术后呛咳、躁动及术中知晓两组差异无统计学意义(P>0.05)。结论丙泊酚联合瑞芬太尼虽在麻醉诱导早期容易出现血压、心率下降,但在气腹后及麻醉中能够维持循环系统的稳定,减少应激反应。

Objective To discuss the clinical effect of propofol combined with remifentanil target controlled infusion on laparoscopy eetopic pregnancy. Methods 120 cases of patients who cured by laparoscopic ectopic pregnancy surgery were selected,and divided into the observation group and the control group,60 cases in each group,the observation group used propofol combined with remifentanil for anesthesia,the control group used propofol combined with fentanyl for anesthesia,and then recorded the intraoperative circulation system changes and the postoperative relevant informations. Results The systolic blood pressure（SBP）and heart rate（HR）of the observation group after anesthesia declined compared with that before anesthesia（P 〈 0.05）;the circulatory fluctuation of the observation group was less than the control group after anesthesia and after pneumoperitoneum（P 〈 0.05）;the wake up time and wake up delay of the observation group were better than the control group after surgery（P 〈 0.05）.The postoperative cough,agitation and intraoperative awareness of the two groups had no significant differenee（P〉 0.05）. Conclusion Using propofol combined with remifentanil in the early anesthesia induction can lead to a drop in blood pressure and heart rate,but it is able to maintain circulation system stability after pneumoperitoneum and anesthesia,and it can reduce the stress response.