七氟烷复合瑞芬太尼麻醉对老年腹腔镜胆囊切除术术后恢复质量的影响研究  

Influence on quality of postoperative recovery of sevoflurance combined reminfentanil in geriatric patients undergoing laparoscopic cholecystomy

作　　者：张韶南[1] 

机构地区：[1]郑州大学第五附属医院麻醉科,河南郑州450052

出　　处：《中国内镜杂志》2010年第7期682-684,688,共4页China Journal of Endoscopy

摘　　要：目的探讨七氟烷复合瑞芬太尼麻醉对老年腹腔镜胆囊切除术(LC)患者术后恢复质量的影响。方法 72例ASAⅠ～Ⅱ级行LC手术患者随机分为观察组和对照组。对照组采用异氟烷复合瑞芬太尼麻醉,观察组采用七氟烷复合瑞芬太尼麻醉。拔管后30min内采用OAAS法进行苏醒质量评分,拔管后3h内采用MMSE测试法进行认知功能测试。结果①两组患者术后均平稳拔管,观察组苏醒时间、拔管时间显著短于对照组(P<0.05)。拔管后两组患者OAAS评分均逐渐增加,观察组拔管后即刻和10min时的OAAS评分显著高于对照组(P<0.05)。②两组患者拔管后认知功能逐渐恢复,观察组在2h内恢复到术前水平,而对照组3h恢复到术前水平,观察组拔管后1和2h认知功能评分显著高于对照组(P<0.05)。结论七氟烷复合瑞芬太尼麻醉可明显缩短老年患者LC术后苏醒时间和拔管时间,加速患者术后认知功能恢复。【Objective】To investigate the influence on quality of postoperative recovery of sevoflurance combined reminfentanil in geriatric patients undergoing laparoscopic cholecystomy （LC）.【Methods】72 patients of ASA Ⅰ～Ⅱ grade＇s LC surgery were randomly divided into observation group and control group. The control group was given anesthesia of the isoflurane combined reminfentanil,the observation group was given anesthesia of sevoflurance combined reminfentanil. The recovery quality score was evaluated by OAAS within 30 min after extubation,the cognitive function score was evaluated by MMSE within 3 h after extubation. 【Results】①The two group＇s patients were given stable extubation,the recovery time and extubation time of the observation group were significantly shorter than the control group （P 0.05）. After extubation the OAAS score of the two group＇s patients were gradually increased,but in immediately after extubation and 10min the OAAS score of the observation group was significantly higher than the control group （P 0.05）. ② After extubation the cognitive function of the two group＇ patients recovered gradually,the observation group returned to preoperative levels within 2 h,the control group returned to preoperative levels within 3 h. 1 h and 2 h after extubation the cognitive function score of observation group was significantly higher than the control group （P 0.05）. 【Conclusion】Sevoflurane with remifentanil anesthesia can significantly shorten the recovery time and extubation time in elderly patients after LC,accelerate the postoperative cognitive recovery.

关 键 词：七氟烷 瑞芬太尼 腹腔镜胆囊切除术 老年患者 

分 类 号：R614.27[医药卫生—麻醉学]