妇科腹腔镜手术中七氟醚与丙泊酚、瑞芬太尼靶控全身麻醉效果的比较被引量：34

A Comparison of General Anesthetic Effects among Sevoflurane Inhalation,Propofol/Remifenant Target-controlled Infusion,and Propofol/Remifenant Target-controlled Infusion Combined Sevoflurane in Gynecologic Laparoscopic Surgery

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摘要目的比较丙泊酚、瑞芬太尼靶控、七氟醚及其静吸复合麻醉3者在妇科腹腔镜手术中全身麻醉的效果。方法行妇科腹腔镜手术患者75例,按随机数字表法分为3组,每组25例,吸入组:七氟醚吸入维持麻醉;静脉组:丙泊酚/瑞芬太尼靶控输注麻醉;静吸组:丙泊酚、瑞芬太尼靶控输注联合七氟醚吸入麻醉。记录患者睁眼时间、气管拔管和定向力恢复时间、苏醒后不良反应。结果 (1)3组患者睁眼时间、拔管时间及定向力恢复时间比较,差异均无统计学意义(P>0.05)。(2)3组患者寒战、躁动比较,差异无统计学意义(P>0.05)。静吸组恶心呕吐1例;吸入组恶心呕吐6例、肠胀气3例,静脉组无明显不良反应,3组不良反应发生率分别为4.0%、36.0%、0,吸入组不良反应发生率明显高于静吸组、静脉组(P<0.05)。3组均无术中知晓、呼吸抑制、舌根后坠发生。结论无论是丙泊酚、瑞芬太尼靶控输注麻醉,七氟醚吸入维持麻醉,还是七氟醚联合丙泊酚、瑞芬太尼静吸复合麻醉,患者都可以快速复苏、拔管,但七氟醚有恶心呕吐不良反应,单纯吸入七氟醚维持麻醉应慎用于胃肠道手术。 Objective To compare the general anesthetic effects of sevoflurane inhalation,propofol/remifenant target-controlled infusion （TCI）, and propofol/remifenant TCI combined sevoflurane in gynecologic laparoscopic surgery. Methods Seventy five patients undergoing gynecologic laparoscopic surgery under general anesthesia were randomly divided into three groups（25 cases for each group）： sevoflurane inhalation group（ Group S）, propofol/remifenant TCI group （Group P）, and propofol/remifenant TCI combined sevoflurane group （Group PS）. The awaking time, extubation time and orientation time were recorded, as well as the incidence of adverse reaction after patients＇ waking up. Results ① There was no significant difference among the three groups in the awaking time, extubation time and orientation time （P 〉 0.05 ）. ② No significant difference was found in the incidence of shivering,restlessness among the three groups （P 〉 0.05）. One case of PONV in Group PS,6 cases of PONV and 3 cases of pneumoperitoneum in Group S, no obvious adverse reaction in Group P ;The incidences of adverse reaction of the three groups were 4.0% ,36.0% ,0, respectively, which were higher in Group S than those in Group P and Group S （ P 〈 0. 05 ）. Intraoperative awareness, respiratory depression and tongue falling backwards did not occur in the three groups. Conclusion Propofol/remifentanil TCI or sevoflurane inhalation or propofol/remifenant TCI combined sevoflurane for anesthesia are all ensuring rapid recovery and extubation, but sevoflurane may cause higher incidence of PONV in the operation. Sevoflurane inhalation would not be suggested for anesthesia in the gastrointestinal surgery.

作者陈序黄秋兰

机构地区广西医科大学第一附属医院麻醉科

出处《广西医学》 CAS 2012年第11期1463-1465,共3页 Guangxi Medical Journal

基金广西自然科学基金(桂科自0991111)

关键词全身麻醉七氟醚丙泊酚瑞芬太尼靶控输注腹腔镜手术妇科手术 General anesthesia Sevoflurane Propofol Remifentanil Target-controlled infusion Laparoscopicsurgery Gynecologic surgery

分类号 R614.2 [医药卫生—麻醉学]

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