丙泊酚、瑞芬太尼复合小剂量咪达唑仑全身麻醉用于妇科腹腔镜手术的效果研究

Effect of general anesthesia with propofol and remifentanil combined with small dose midazolam for gynecologic iaparoscopic surgery

目的研究丙泊酚、瑞芬太尼复合小剂量咪达唑仑全身麻醉用于妇科腹腔镜手术的效果。方法选取我院2015年3～12月收治的妇科腹腔镜手术患者160例，依据随机数字表法将这些患者分为丙泊酚、瑞芬太尼复合小剂量咪达唑仑全身麻醉组（研究组，n=80）和丙泊酚、瑞芬太尼全身麻醉组（对照组，n=80）两组，对两组患者的血流动力学、麻醉起效时间、呼吸恢复时间、拔管时间、丙泊酚用量及不良反应发生情况进行统计分析。结果气腹后5min研究组患者的HR、SBP、DBP均显著低于对照组（P〈0．05），麻醉前、气腹前和完成手术时两组患者的HR、SBP、DBP比较差异均不显著（P〉0．05），研究组麻醉起效时间、呼吸恢复时间、拔管时间均显著短于对照组（P〈O．05），丙泊酚用量显著少于对照组（P〈O．05），不良反应发生率7．5％（6／80）显著低于对照组15．0％（12／80）（P〈O．05）。结论丙泊酚、瑞芬太尼复合小剂量咪达唑仑全身麻醉用于妇科腹腔镜手术具有较好的麻醉效果和安全性。

Objective To study the effect of propofol,remifentanil combined with low-dose midazolam general anesthesia in the application of gynecological laparoscopic surgery. Methods 160 cases of patients undergoing gynecologic laparoscopic surgery from Mar. to Dec. 2015 were selected, they were divided into propofol, remifentanil combined with low- dose midazolam general anesthe- sia （study group, n = 80） and propofol, remifentanil anesthesia group （control group, n = 80） two groups according to a random ta- ble, the hemodynamics, onset time of anesthesia, respiration recovery time, extubation time, propofol dosage and incidence of adverse reactions were statistically analyzed. Results The HR,SBP and DBP after pneumoperitoneum 5min of the study group were signifi- cantly lower than the control group （P〈0.05）, the differences of HR, SBP,DBP before anesthesia,before pneumoperitoneum and completion of surgery between the two groups were not significant （P〉0.05）, the onset time of anesthesia, breathing recovery time and extubation time of the study group were significantly shorter than the control group （P〈0. 05） ,the propofol was significantly lower than the control group （P〈0.05） ,the incidence of adverse reactions 7.5 % （6/80） was significantly lower than the control group 15% （12/80） （P〈0.05）. Conclusion The anesthetic effect and safety of propofol,remifentanil combined with low-dose mi- dazolam general anesthesia in the application of gynecological laparoscopic surgery are better.