全凭静脉麻醉在妇科腹腔镜手术中的应用  

A Clinical Study of Total Intravenous Anaesthesia in Laparoscopic Operation

作　　者：吴莉[1] 潘杰[1] 赵波[1] 刘晓霞[1] 王婧琪[1] 

机构地区：[1]哈尔滨市第一医院麻醉科,哈尔滨150010

出　　处：《中国现代医生》2009年第11期30-31,共2页China Modern Doctor

摘　　要：目的评价瑞芬太尼复合丙泊酚全凭静脉麻醉术中血流动力学变化和术后苏醒过程。方法ASAⅠ～Ⅱ级择期腹腔镜手术患者40例,随机分为全凭静脉麻醉组(A组)(n=20)和静吸复合麻醉组(B组)(n=20)。A组麻醉维持采用瑞芬太尼复合丙泊酚持续泵注;B组术中吸入1%～2%异氟烷、50%N2O维持麻醉。记录各时段血压、心率。观察术毕停药后患者恢复情况。结果①A组CO2气腹前后相比较及苏醒期与诱导前相比较,血压、心率无显著性变化。②两组自主呼吸恢复时间、呼之睁眼时间、拔管时间A组显著快于B组(P<0.01)。③术后恶心、呕吐发生率无显著性差异,两组均无术中知晓。结论与静吸复合相比,瑞芬太尼全凭静脉麻醉血流动力学更稳定、苏醒迅速、苏醒质量更高。Objective To evaluate the recovery and hemodynamics of total intravenous anaesthesia（TIVA） with propofol and remifentanil. Methods Forty ASA Ⅰ～Ⅱ patients undergoing laparoscopic operation were randomly divided into the TIVA group（group A, n = 20） and the combined intravenous with inhalation anaesthesia group （group B, n = 20）. In group A, remifentanil and propofol was infused with an infusion pump to maintain anaesthesia. In group B, 1% -2% Isoflurane and 50% N2O were inhaled to maintain anaesthesia. BP,HR at all stages and recovery profiles were recorded. Results （1）Between before inflation and after inflation or between at the end of operation and the basic values in group A,there were no significant differences in BP,HR. （2）Recovery times were significantly less in group A than group B. （3）The side effects were similar between groups. Conclusion The application of TIVA with propofol and remifentanil is associated with better hemodynamic stability and better recovery profile as compared to the combined intravenous with inhalation anaesthesia.

关 键 词：瑞芬太尼 丙泊酚 全凭静脉麻醉 

分 类 号：R614[医药卫生—麻醉学]