不同剂量瑞芬太尼联合丙泊酚用于腹腔镜手术的麻醉效果比较

The comparison of anesthetic effect with different dosage of remifentanil combined with propofol on laparoscopic surgery

目的：比较不同剂量瑞芬太尼联合丙泊酚用于腹腔镜手术的麻醉效果。方法选取2010年6月至2013年6月间于我院接受诊断和治疗的腹腔镜手术患者96例，采用随机数字表法将所有患者随机分为 A 组、B 组和 C 组三组，每组32例。观察比较不同时刻 BIS 值以及血流动力学参数和不良反应发生率。结果 A、B、C 三组患者 T1~4时刻 BIS 值均明显小于 T0时刻（P ﹤0.05），C 组患者 T1-4时刻 HR、MAP 以及 BIS 值均明显小于 B 组（P ﹤0.05）。与 A 组比较，B、C 两组患者体动反应发生率明显降低，而呼吸抑制的发生率明显升高（ P ﹤0.05）；与B 组比较，C 组患者体动反应发生率明显降低，而心动过缓、呼吸抑制以及低氧血症的发生率明显升高（P ﹤0.05）。结论瑞芬太尼血浆靶控浓度为6 ng/ ml 时，联合丙泊酚用于腹腔镜手术的麻醉效果最佳，值得在临床中推广应用。

Objective：To compare the anesthetic effect with different dosage of Remifentanil combined with Propofol on laparoscopic surgery. Methods：Ninty-six patients with laparoscopic surgery were selected and randomly divided into the Group A,Group B and Group C and each had 32 cases. The BIS and hemodynamic parameters of different time and the in-cidence of adverse reactions were observed and compared. Results：The BIS of T1 to T4 were obviously lower than that of T0（P ﹤ 0. 05）. The HR,MAP and BIS of Group C were obviously lower than those of Group C（P ﹤ 0. 05）. The inci-dence of Movement in response of Group B and Group C were obviously lower than that of Group A while the incidence of Respiratory depression of Group B and Group C were obviously higher than that of Group A（P ﹤ 0. 05）. The incidence of movement in response of Group C were obviously lower than that of Group B while the incidence of respiratory depression of Group C were obviously higher than that of Group B（P ﹤ 0. 05）. Conclusion：When the target concentration in plasma of Remifentanil is 6ng/ ml,it produces the best anesthetic effect on laparoscopic surgery compared with Propofol and deserved promotion.