摘要
目的评价瑞芬太尼-异丙酚靶控静脉麻醉在妇科腹腔镜手术中的疗效。方法选择2000-2006年择期妇科腹腔镜手术患者120例,ASAI～Ⅱ级,年龄19～57岁,体重40～75kg。随机分为微量泵输注瑞芬太尼-异丙酚组(I组,60例)和芬太尼异氟醚组(Ⅱ组,60例)。术中连接多功能监护仪,观察围术期两组血流动力学变化,入室至麻醉苏醒期间持续监测动脉收缩压(SBp)、舒张压(DBp)、心率(HR)、氧饱和度(SpO2)。结果两组中T1、T2和T3的SBp、DBp、HR值与基础值(T0)相比,均显著下降(P<0.05);气腹后10min(T2)Ⅱ组SBp、DBp、HR值均高于I组,Ⅱ组气腹毕(T3)SBp、DBp高于I组(P<0.05),I组术中各时段血压与诱导前相比低且平稳;Ⅰ组病人术后自主呼吸恢复时间、睁眼时间及拔管时间较Ⅱ组明显缩短(P<0.05)。结论微量泵输注瑞芬太尼-异丙酚麻醉应用于妇科腹腔镜手术,诱导更加平稳,苏醒迅速,有效且安全。
Objective To evaluate the anesthetic effects of gynecologic laparoscopic operations by infusing propofol and remifentanil with minimum pump. Methods A total of 120 ASA physical status Ⅰ and Ⅱ patients aged 19～57 yrs and weighted 40～ 75 kg undergoing gynecologic laparoscopic operations from 2000 to 2006 were randomly divided into 2 groups （n = 60 each）, Group Ⅰ of propofol and remifentanil pumped via target controlled infusion and Group Ⅱ of regular intravenous - inhalation combination. Hemodynamic variables including SBp, DBp, HR, and SpO2 were monitored by hemodynamic monitors in all the patients. Results Compared with the baseline values, the SBp, DBp, HR values of the two groups were decreased significantly （P〈0.05） at T1, T2, and T3 measure points. The values of SBp, DBp, and HR in group Ⅱ were higher than those of group Ⅰ at T2 （10 minutes after pneumoperitoneum）, and the values of SBp and DBp in groupⅡ were higher than those of group Ⅰ （P〈 0.05） at T3 （after pneumoperitoneum）. Compared with blood pressure before anesthesia inducing, blood pressures at all the measure points during the operation were low and stable in group Ⅰ . The interval between the termination of anesthetics and the full recovery of spontaneous breathing, eye opening at request and tracheal extubation in group Ⅰ were significantly shorter than those of group Ⅱ （P〈 0.05）. Conclusions Comparing to the regular intravenous inhalation anesthesia, the anesthetic induction by target - controlled infusing propofol and remifentanil is more effective and safe in gynecological laparoscopic operations, and has more stabler perioperative hemodynamics and quick analepsia.
出处
《实用预防医学》
CAS
2008年第1期174-175,共2页
Practical Preventive Medicine
关键词
异丙酚
瑞芬太尼
麻醉
妇科
腹腔镜
Propofol
Remifentanil
Anesthesia
Gynecology
Laparoscopy
