丙泊酚复合瑞芬太尼靶控输注麻醉对急性阑尾炎患者行腹腔镜阑尾切除术术后自主呼吸及拔管时间的影响

Effects of Propofol Combined with Remifentanil Target-controlled Infusion on Spontaneous Breathing and Extubation Time in Patients Undergoing Acute Appendicitis after Laparoscopic Appendectomy

目的:丙泊酚复合瑞芬太尼靶控输注麻醉对急性阑尾炎患者行腹腔镜阑尾切除术术后自主呼吸及拔管时间的影响。方法:选取潢川县人民医院行腹腔镜阑尾切除术治疗急性阑尾炎患者76例,随机数字表法分组,各38例。观察组采用丙泊酚+瑞芬太尼靶控输注麻醉,对照组采用丙泊酚+芬太尼静脉麻醉。观察比较两组不同时间段平均动脉压(MAP)水平及麻醉效果。结果:观察组麻醉诱导后、插管前、人工气腹后MAP水平波动较小,优于对照组,差异均有统计学意义(P<0.05),两组麻醉诱导前、手术完成时、拔管时MAP水平比较,差异无统计学意义(P>0.05);观察组麻醉起效时间、自主呼吸时间、清醒时间、拔管时间、麻醉恢复时间短于对照组,差异均有统计学意义(P<0.05)。结论:丙泊酚复合瑞芬太尼靶控输注麻醉应用于急性阑尾炎行腹腔镜阑尾切除术患者,可稳定患者手术过程中平均动脉压水平,并缩短麻醉起效时间、自主呼吸时间、拔管时间及麻醉恢复时间,麻醉效果较好。

Objective:To investigate the effects of propofol combined with remifentanil target infusion on spontaneous breathing and extubation timein patients undergoing acute appendicitis after laparoscopic appendectomy.Methods:76patients with acute appendicitis underwent laparoscopicappendectomy in our hospital were randomly divided into control group and observation group,with38cases in each group.The control groupwas treated with propofol+remifentanil target-controlled infusion anesthesia,the control group using propofol+fentanyl intravenous anesthesia.Themean arterial pressure(MAP)level and anesthesia effect in different time periods of the two groups were compared.Results:The MAP level ofthe observation group was significantly lower than that of the control group before and after intubation,the difference was statistically significant(P<0.05),there was no significant difference in MAP level between the two groups before and after the induction of anesthesia(P>0.05);The durationof anesthesia onset,spontaneous breathing time,awake time,extubation time and anesthesia recovery time in the observation group were shorter thanthose in the control group,the difference was statistically significant(P<0.05).Conclusion:Propofol combined with remifentanil target-controlledinfusion anesthesia in the treatment of patients with acute appendicitis laparoscopic appendectomy can stabilize the average arterial pressure duringsurgery,and shorten the onset time of anesthesia,spontaneous breathing time,extubation time,and anesthesia recovery time is shorter,thus,theanesthesia effect is better.