摘要
目的研究丙泊酚TCI全凭静脉麻醉与异氟醚静吸复合麻醉对腹腔镜胆囊切除术后苏醒速度及PONV的影响。方法90例择期行腹腔镜胆囊切除术的患者 ,ASAⅠ Ⅱ级 ,随机分成丙泊酚TCI组 (Ⅰ组 )和异氟醚静吸复合组 (Ⅱ组 ) ,均以丙泊酚 -芬太尼 -阿曲库铵诱导 ,插管后Ⅰ组以丙泊酚TCI维持麻醉至缝皮前 ,靶浓度为 3μg/mL ,Ⅱ组持续吸入 2 %异氟醚 (氧流量为2L/min)至缝皮前 ,关闭吸入麻醉后使用回路内麻醉气体吸附器促进苏醒。术中按需追加芬太尼与阿曲库铵。两组病人分别记录 :术前 ,术中 1、5、10min及术后MAP和HR ;麻醉停止至拔管的时间以及清醒、定向力恢复的时间 ;麻醉用药量及术后d1随访有无恶心呕吐 (PONV)。结果Ⅰ组各时段MAP及HR与Ⅱ组间无显著差异 ,同组各时段MAP及HR除术始后 1min有所下降 (P<0 .0 5 )外 ,其余也无显著差异。Ⅰ组麻醉停止至拔管时间、清醒及定向力恢复时间明显短于Ⅱ组 ,术后PONV发生率也明显低于Ⅱ组 (均P <0 .0 5 )。结论丙泊酚TCI全凭静脉麻醉用于腹腔镜之短小手术 。
Objective To compare the recovery time and PONV in patients unclecgtay laparoscopic operation using propofol TCI anesthesia with that intravenous combined inhalation anesthesia. Methods Ninety 18 to 60 years old patients with ASA ⅠorⅡ scheduled for laparoscopic cholecystectomy were enrolled in this study. They were randomized divided into two groups: the propofol TCI group(groupⅠ)and the isoflurane-maintenance group(groupⅡ). All patients were induced with propoful-fentanil- ATC. In groupⅠ,TCI propoful was maintained after intubation until incision closure with target-concentration 3 μg/mL. In groupⅡ, isoflurane(end-tidal concentration of 2%)was maintained until incision closure,and anesthetic gas absorber was used then. Following index were recorded in both groups: MAP and HR preoperatively,1,5,10 min postoperatively and at the end of operation;the duration from the end of anesthesia to extubation and recovery respectively;the dosage of TCI propofol or isoflurane;nausea and vomiting in the first postoperative day. Results There were no difference in MAP and HR between both groups. The durations from the end of anesthesia to extubation and recovery were significantly shorter in groupⅠ than those in groupⅡ(P<0.05) and the rate of PONV was also significantly lower in groupⅠ. Conclusion Compared with isoflurane inhalation combined intravenous anesthesia, TCI propoful anesthesia has the advantages of quick recovery, lower rate of PONV in operations such as laparoscopy in which it usually needs little time.
出处
《上海第二医科大学学报》
CSCD
2004年第11期942-944,共3页
Acta Universitatis Medicinalis Secondae Shanghai
关键词
丙泊酚TCI
异氟醚
复合麻醉
腹腔镜手术
术后恢复
propofol TCI
total intravenous anesthesia
isoflurane
intravenous combined inhalation anesthesia
laparoscopy
recovery time
postoperative nausea and vomiting
