不同剂量瑞芬太尼对腹腔镜子宫全切除术后患者血流动力学的影响  

Influence of different doses of remifentanil on postoperative hemodynamics in patients undergoing laparoscopic total hysterectomy

作　　者：都淑萍[1] 王晓东[1] 李雪艳[1] Du Shuping;Wang Xiaodong;Li Xueyan(Department of Anesthesiology,Weihai Municipal Hospital,Weihai,Shando.ng 264200,China)

机构地区：[1]威海市立医院麻醉室,山东省威海264200

出　　处：《中国基层医药》2018年第23期3016-3019,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨不同剂量瑞芬太尼对腹腔镜子宫全切除术后患者血流动力学的影响。方法选取威海市立医院2016年1~12月行腹腔镜子宫全切除术的患者90例为观察对象,采用随机数字表法将其分成A组(瑞芬太尼0.2 μg·kg^-1·min^-1)、B组(瑞芬太尼0.3 μg·kg^-1·min^-1)、C组(瑞芬太尼0.5 μg·kg^-1·min^-1)各30例,对比各组手术相关指标(手术时间、麻醉时间、拔管时间、镇痛时间)、各组不同时期(T0:手术前;T1:术后即刻;T2:术后1 d;T3:术后3 d)的心率(HR)及平均动脉压(MAP),并记录和对比各组不良反应。结果各组手术相关指标差异均无统计学意义(F=1.278、1.346、0.987、2.232,均P>0.05)。A组、B组、C组T1时HR及MAP分别为(94.68±8.51)次/min和(105.84±11.37)mmHg、(81.82±9.17)次/min和(97.14±9.02)mmHg、(75.24±8.29)次/min和(82.39±10.87)mmHg,A组HR及MAP水平均高于B组、C组(t=5.630、3.283、8.962、8.165,均P<0.05),B组HR及MAP水平均高于C组(t=2.915、5.720,均P<0.05)。A组T1时的HR及MAP明显高于T0、T2及T3时的水平(t=7.118、6.249、6.977,均P<0.05;t=3.632、3.728、3.717,均P<0.05),C组T1时的HR及MAP明显低于T0、T2及T3时的水平(t=2.060、2.043、2.068,均P<0.05;t=5.429、5.549、5.341,均P<0.05),B组T0~T3时的HR及MAP差异均无统计学意义(t=1.408、0.529、1.106,均P>0.05;t=0.480、0.430、0.437,均P>0.05)。各组不良反应总发生率差异无统计学意义(χ^2=3.069,P>0.05)。结论 不同剂量的瑞芬太尼对腹腔镜子宫全切除术患者术后血流动力学的影响较大,而0.3 μg·kg^-1·min^-1的剂量较为稳定,值得重视。Objective To study the influence of different doses of remifentanil on postoperative hemodynamics in patients undergoing laparoscopic total hysterectomy.Methods Ninety patients underwent laparoscopic total hysterectomy in Weihai Municipal Hospital were selected as the subjects,and they were divided into A group(0.2μg/kg·min remifentanil),B group(0.3μg/kg·min remifentanil),C group (0.5μg/kg·min remifentanil) according to the random number table method,with 30 cases in each group.The relative operative indicators(including operation time,anesthesia time,extubation time and analgesia time) of the three groups were compared,and compared the heart rate (HR) and mean arterial pressure (MAP) in the three groups at different stages (T0: preoperation,T1: immediately after operation,T2: one day after operation,T3: three days after operation). The adverse reactions were recorded and compared.Results There were no statistically significant differences on relative operative indicators among the three groups (F=1.278,1.346,0.987,2.232,all P>0.05). The levels of HR and MAP in A group,B group and C group at T1 were (94.68±8.51)times/min and (105.84±11.37)mmHg,(81.82±9.17)times/min and (97.14±9.02)mmHg,(75.24±8.29)times/min and (82.39±10.87)mmHg,respectively.The levels of HR and MAP in A group were higher than those in B group and C group (t=5.630,3.283,8.962,8.165,all P<0.05). The levels of HR and MAP in B group were higher than those in C group(t=2.915,5.720,all P<0.05). The HR and MAP of A group at T1 were higher than those of T0,T2 and T3 (t=7.118,6.249,6.977,all P<0.05,t=3.632,3.728,3.717,all P<0.05). The HR and MAP of C group at T1 were lower than those of T0,T2 and T3 (t=2.060,2.043,2.068,all P<0.05,t=5.429,5.549,5.341,all P<0.05). There were no statistically significant differences in HR and MAP of B group at T0,T2 and T3 (t=1.408,0.529,1.106,all P>0.05,t=0.480,0.430,0.437,all P>0.05). There was no statistically significant difference in the total incidence of adverse reactions among the three groups (χ^2=3.0

关 键 词：腹腔镜检查 子宫切除术 血流动力学 瑞芬太尼 

分 类 号：R614[医药卫生—麻醉学]