瑞芬太尼和丙泊酚合剂用于全身麻醉的效果观察

Remifentanil-propofol's effects on general anesthsia

目的观察瑞芬太尼和丙泊酚合剂应用于全身麻醉术中维持的患者苏醒质量和丙泊酚用药量情况。方法选择拟全麻下行腹腔镜胆囊切除术患者51例,年龄25~55岁,BMI〈25 kg/m2,ASAⅠ级。采用随机数字表法,将患者随机分为2组：R组（26例）和C组（25例）。R组术中维持以7.5~10μg/（kg·h）（以瑞芬太尼计算）的速度持续静脉泵入瑞芬太尼和丙泊酚合剂;C组用双通道微量注射泵分别以7.5~10μg/（kg·h）和4~12 mg/（kg·h）的速度持续静脉泵入瑞芬太尼和丙泊酚,术中根据BIS值调节丙泊酚输注速度。两组均维持BIS值在40~60之间,均吸入66%笑气,新鲜气流量为2 L/min。记录并比较两组患者麻醉时间、术中丙泊酚和瑞芬太尼用药量、手术结束停止麻醉药物后BIS值恢复时间、睁眼时间、拔管时间、患者送至术后恢复室（PACU）后Aldrete评分≥9分的时间和不良反应发生率。结果与C组相比,R组患者单位时间单位体重所用丙泊酚剂量较少,BIS值恢复时间、睁眼时间、拔管时间、患者送至术后恢复室（PACU）后Aldrete评分≥9分的时间均少于C组,不良事件发生率两组比较差异无统计学意义。结论瑞芬太尼与丙泊酚合剂用于全身麻醉维持能维持适宜的麻醉深度,丙泊酚用量较少,苏醒快,苏醒质量较高。

Objective To research the scores on anesthesia recovery period and the quantity of propofol used in the surgery on general anesthesia with remifentanil-propofol＇s.Methods 51 ASA Ⅰ grade patients who were going to have laparoscopic cholecystectomy,aged 25 to 55 year-old,BMI25 kg/m2,were randomly allocated to remifentanil group（group R） and control group（group C）.Group R intravenous（iv.） remifentanil-propofol＇s at the speed of 7.5 ~10 μg /（kg·h）（based on renifetanil）,while group C used remifentanil and propofol at the speed of 7.5 ~ 10 μg /（kg·h）and 4 ~ 12 mg /（kg·h） during the surgery to maintain the BIS value between 40 and 60,60.66% N2O were added in both group with 2 L/min fresh flow.The quantity of propofol and remifentanil used in the anesthesia sustain period,the time of BIS value recovery,patients recovery,extubation,Aldrete score reach 9 and the adverse reactions in the two groups were compared.Results Compared with group C,the quantity of propofol used in group R was significantly decreased.In addition,the time of BIS value recovery,patients recovery,extubation and the time of Aldrete score reach9 in group R were all less than that in group C.There was no significant difference between the two groups in adverse events.Conclusion Remifentanil-propofol＇s can provide a satisfying depth of anesthesia in general anesthesia and result in good recovery score with less propofol.