依托咪酯与芬太尼及瑞芬太尼静脉全麻用于腹腔镜子宫肌瘤剔除术的比较研究  

Relying on the Comparative Study of Etomidate and Fentanyl and Remifentanil Intravenous Anesthesia for Laparoscopic Myomectomy

作　　者：程连臣 于慧军[1] 

机构地区：[1]临汾市第四人民医院麻醉科,山西临汾041000

出　　处：《中国医药指南》2013年第12期628-629,共2页Guide of China Medicine

摘　　要：目的比较依托咪酯乳剂与芬太尼及瑞芬太尼静脉全身麻醉用于腹腔镜子宫肌瘤剔除术对血压(BP)、心率(HR)、血皮质醇、儿茶酚胺和血气分析的影响。方法将60例行腹腔镜子宫肌瘤剔除术的患者随机分成两组,即例依托咪酯复合芬太尼组(A组,30)和依托咪酯复合瑞芬太尼组(B组,30例)。术中连续监测HR、BP和SpO2,分别分时段进行血气分析及肾上腺素(E)、去甲肾上腺素(NE)及皮质醇(COS)浓度的测定。结果①气腹时A组HR和BP均显著性增高(P<0.05);B组各项指标则无显著性变化(P>0.05)。②气腹时两组PaO2、HCO3—均显著性增高(P<0.05),但是两组间各指标无显著性差异(P>0.05)。③NE、E及COS浓度,气腹时A组有显著性差异(P<0.05),B组则无显著性差异(P>0.05)。结论依托咪酯乳剂和瑞芬太尼静脉全麻用于腹腔镜子宫肌瘤剔除术时机体应激反应轻,是较理想的麻醉方法。Objective To compare the effects of etomidate emulsion combined with fentanyl on blood pressure（BP）, heart rate（HR）, cortisol, catecholamine and blood gas analysis with etomidate emulsion combined with remifentanil under general anaesthesia in lapamscopic myomectomy. Methods 60 cases of patients with laparoscopic myomectomy were randomLy divided into etomidate emulsion combined with fentanyl group（Group A, n=30）and etomidate emulsion combined with remifentanil group（Group B, n=30）.HR, BP and SpO2 were monitored. Blood gas and the concentrstions of epinephrine（E）, norepinephrine（NE）and cortisol（COS） were measured. Results （1）HR and BP were increased significantly（P〈0.05）during pneumoperitoneum in group A, but not in group B（P〉0.05）.（2）PaO2 and HCO3-were increased significantly in the two groups（P〈0.05）, but had no significant difference between the two groups（P〉0.05）. （3）The concentrations of NE, E and COS were increased significantly in group A during pneumoperitoneum, but not markedly changed in group B（P〉0.05）. Conclusion Etomidate emulsion combined with remifentanil may alleviate the stress response to surgery under general anaesthesia in laparoscopic myomectomy and be an ideal technique for laparoscopic myomectomy.

关 键 词：全身麻醉 依托咪酯乳剂 芬太尼 瑞芬太尼 腹腔镜子宫肌瘤剔除术 

分 类 号：R737.33[医药卫生—肿瘤]