瑞芬太尼联合丙泊酚在腹腔镜胆囊切除术中的应用效果

Application effect of Remifentanil combined with Propofol in laparoscopic cholecystectomy

目的探讨瑞芬太尼联合丙泊酚在腹腔镜胆囊切除术中的应用效果。方法选取2018年1月~2019年1月我院收治的100例腹腔镜胆囊切除术患者作为研究对象,按照双盲法随机分为实验组(n=50)和对照组(n=50)。对照组采用芬太尼与丙泊酚复合麻醉,实验组采用瑞芬太尼与丙泊酚复合麻醉。比较两组麻醉前后的血流动力学指标水平、麻醉效果及不良反应情况。结果实验组麻醉后的收缩压(SBP)、平均动脉压(MAP)、舒张压(DBP)、心率(HR)及血氧饱和度(SpO2)水平与麻醉前比较,差异无统计学意义(P>0.05);对照组麻醉后的SBP、DBP、HR和SpO2水平均低于麻醉前,MAP水平高于麻醉前,差异有统计学意义(P<0.05);实验组麻醉后的SBP、DBP、HR、SpO2水平均高于对照组,MAP水平低于对照组,差异有统计学意义(P<0.05);实验组的气管导管拔除时间、清醒时间及恢复自主呼吸时间均短于对照组,差异有统计学意义(P<0.05);实验组的不良反应总发生率(6.00%)低于对照组(20.00%),差异有统计学意义(P<0.05)。结论腹腔镜胆囊切除术患者接受瑞芬太尼与丙泊酚复合麻醉,能调节患者的血流动力学指标水平,缩短患者的气管导管拔除时间、清醒时间及恢复自主呼吸时间,降低不良反应发生率,值得临床推广应用。

Objective To investigate the application effect of Remifentanil combined with Propofol in laparoscopic cholecystectomy.Methods A total of 100 patients undergoing laparoscopic cholecystectomy treated in our hospital from January 2018 to January 2019 were selected as the research subjects and randomly divided into the experimental group(n=50)and the control group(n=50)according to the double-blind method.The control group anesthetized with Fentanyl and Propofol,and the experimental group anesthetized with Remifentanil and Propofol.The hemodynamic index levels before and after anesthesia,anesthetic effects and adverse reactions were compared between the two groups.Results There were no significant differences in systolic blood pressure(SBP),mean arterial pressure(MAP),diastolic blood pressure(DBP),heart rate(HR),and blood oxygen saturation(SpO2)levels in the experimental group before and after anesthesia(P>0.05).The levels of SBP,DBP,HR and SpO2 after anesthesia in the control group were lower than those of before anesthesia,and the levels of MAP was higher than that of before anesthesia,the differences were statistically significant(P<0.05).The levels of SBP,DBP,HR,and SpO2 in the experimental group after anesthesia were higher than those in the control group,and the levels of MAP was lower than that in the control group,the differences were statistically significant(P<0.05).The tracheal tube removal time,awake time and spontaneous breathing time of the experimental group were shorter than those of the control group,the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the experimental group(6.00%)was lower than that in the control group(20.00%),the difference was statistically significant(P<0.05).Conclusion Patients undergoing laparoscopic cholecystectomy receive Remifentanil and Propofol combined anesthesia,which can adjust the hemodynamic index level of the patient,shorten the tracheal catheter removal time,wake time and restore spontaneous breathing time,reduce the incidence of adverse reactions,which is worthy of clinical application.