瑞芬太尼诱导在加速康复外科腹腔镜胆囊切除术中的应用

Clinical Values of Remifentanil Induction in Patients with Laparoscopic Cholecystectomy for Enhancing Recovery after Surgery

目的:探讨瑞芬太尼诱导在加速康复外科腹腔镜胆囊切除术的应用价值。方法:择期行腹腔镜胆囊切除术患者60例,ASAⅠ～Ⅱ级,随机分为2组(n=30),瑞芬太尼组(R组)和芬太尼组(F组)。R组给予瑞芬太尼2μg/kg进行麻醉诱导,F组给予芬太尼2.4μg/kg进行麻醉诱导。观察记录两组患者麻醉中血流动力学、手术时间、术毕拔管时间、术后肛门排气时间及排便时间,并随访术后疼痛及术后恶心呕吐发生情况。结果:R组术毕拔管时间、术后肛门排气、排便时间缩短,R组术后恶心呕吐发生率明显低于F组(P<0.05)。结论:瑞芬太尼诱导有利于缩短麻醉恢复时间,减少术后恶心呕吐发生率,提高加速康复外科腹腔镜胆囊切除术的质量。

Objective： To investigate the clinical values of remifentanil induction in laparoscopic cholecystectomyfor enhance recovery after surgery. Methods：Sixty ASAⅠ～Ⅱ patients undergoing laparoscopic cholecystectomy wererandomly divided into 2 groups（n=30 each）,remifentanil group（group R）and fentanyl group（group F）. Group Rreceived remifentanil 2 μg/kg for induction,and F group received fentanyl 2.4μg/kg for induction. The hemodynamics,the time of operation,extubation,postoperative anus exhaust and defecation were recorded,and the postoperative pain andpostoperative nausea and vomiting were observed in two groups. Results：The time of extubation,postoperative analexhaust and defecationin group R weresignificantly shorter than those in group F（P 〈0.05）. The number of cases ofpostoperative nausea and vomitingin group R was significantlylower than that in group F. Conclusion：Remifentanilinduction is beneficial to shorten the time of recovery of anesthesia,reduce the incidence of postoperative nausea andvomiting,and improve the quality of laparoscopic cholecystectomyfor enhance recovery after surgery.