丙泊酚复合瑞芬太尼静脉全身麻醉在腹腔镜胆囊手术中的应用

Application of intravenous general anaesthesia using propofol combined with remifentanil in laparoscopic operation on gallbladder

目的探讨丙泊酚复合瑞芬太尼静脉全身麻醉在腹腔镜胆囊手术中的作用效果。方法将2007年1月～2010年12月实施腹腔镜胆囊手术的100例患者随机分为两组：A组50例，采用丙泊酚复合瑞芬太尼静脉麻醉；B组50例，采用丙泊酚复合芬太尼静脉麻醉，比较两组的生命体征变化、麻醉恢复时间、麻醉效果等指标。结果两组术中生命体征的各项指标平稳，两组间比较，差异无显著性（P〉0．05），A组术后麻醉恢复较B组快，两组自主呼吸恢复时间、拔管时间、睁眼时间和定向力恢复时间相比，差异有显著性（P〈0．05），A组麻醉效果的优良率为96．0％，B组84．0％，差异有显著性（P〈0．05）。结论丙泊酚复合瑞芬太尼静脉麻醉用于腹腔镜胆囊手术安全可行，麻醉满意，苏醒快，值得临床应用。

[ Objective ] To explore the clinical effect of intravenous general anaesthesia using propofol combined with remifentanil in laparoscopic operation on gallbladder. [Methods] 100 patients, who underwent laparoscopic operation on gallbladder from January 2007 to December 2010 in our hospital, were randomly divided into two groups： 50 patients in group A received intravenous general anaesthesia using propofol combined with remifentanil and 50 patients in group B received intravenous general anaesthesia using propofol combined with fentanil. A com- parative analysis was subsequently performed between the two groups in vital signs, post-anaesthesia recovery time and anaesthetic effect. [ Results ] There was no statistically significant difference between the two groups in the in- dexes of vital signs （P 〉0.05）. Post-anaesthesia recovery time in group A was significantly shorter than that in group B in spontaneously breathing recovery time, extubating time, opening eyes time in response to calling and orientation force recovery time （P 〈0.05）. The excellent rate of intravenous general anaesthesia in group A （96%） was signifi- cantly higher than that in group B （84.0%） （P 〈0.05）. [ Conclusion ] Intravenous general anaesthesia using propofol combined with remifentanil deserves being applied in laparoscopic operation on gallbladder owing to its safety and feasibility, satisfactory anesthesia, rapid analepsia.