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Clinical investigation of total intravenous anesthesia with remifentanil and propofol in larparoscopic cholecystectomy
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- Author:
- No author available
- Journal Title:
- CHINA CLINICAL PRACTICAL MEDICINE
- Issue:
- 3
- DOI:
- No doi available
- Key Word:
- 全凭静脉麻醉;异丙酚;瑞芬太尼;腹腔镜胆囊切除术
Abstract： 目的 研究瑞芬太尼-异丙酚全凭静脉麻醉在腹腔镜胆囊切除术(LC)的应用及其效果评价.方法 择期LC手术患者40例,随机等分为两组.两组均以异丙酚2mg/kg,维库溴胺0.12mg/kg、瑞芬太尼2μg/kg按顺序麻醉诱导后气管插管.麻醉维持:试验组(R组)经静脉持续微泵泵注瑞芬太尼0.05～0.1μg/(kg·min)和异丙酚4～8mg/(kg·h);对照组(C组)以1%～2%异氟醚持续吸入维持麻醉.记录麻醉诱导前、气腹前、气腹后5min、气腹毕和术毕的收缩压(SBP)、舒张压(DBP)、心率(HR)、呼之睁眼时间、拔管时间和清醒程度及不良反应.结果 R组呼之睁眼时间、拔管时间明显低于C组(P＜0.05),OAAS评分明显高于C组(P＜0.05).与诱导前比较,R组SBP、DBP在各时间点无明显变化,HR在气腹前、气腹后5min、气腹毕、术毕明显减慢(P＜0.01);C组在气腹后5min SBP、DBP明显增高(P＜0.01),HR在气腹后5min、气腹毕明显增快(P＜0.05或P＜0.01).组间比较,R组SBP、DBP在气腹后5min明显低于C组(P＜0.01);HR在气腹前、气腹后5min、气腹毕、术毕明显低于C组(P＜0.05或P＜0.01).R组术后恶心呕吐明显低于C组(P＜0.05).结论 瑞芬太尼-异丙酚全凭静脉麻醉用于LC手术,具有麻醉效果满意、血液动力学稳定、苏醒快速、术后恶心呕吐率低、无空气污染等优点.
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