瑞芬太尼应用于腹腔镜下胆囊切除术的麻醉效果观察  

Anesthetic effect observation of remifentanil applying to laparoscopic cholecystectomy

作　　者：周丽丽[1] 郭鸿雁[1] 王军[1] 王学涛[1] 

机构地区：[1]山东中医药大学第二附属医院麻醉科,济南250001

出　　处：《中国当代医药》2015年第36期32-34,共3页China Modern Medicine

摘　　要：目的探讨瑞芬太尼应用于腹腔镜胆囊切除术的可行性及安全性。方法选取2013年12月~2014年12月于我院行腹腔镜下胆囊切除术治疗的70例患者作为研究对象,将其随机分为观察组和对照组,每组35例。给予对照组瑞芬太尼麻醉,观察组芬太尼麻醉,观察比较两组临床麻醉效果。结果观察组术后恢复自主呼吸时间为（2.7±0.4）min、苏醒时间为（7.1±1.6）min、拔管时间为（7.8±1.7）min、恢复定向力时间为（9.4±2.5）min,均优于对照组（P〈0.05）;观察组拔管后即刻状态、1 h后状态及3 h后状态均明显优于对照组,差异有统计学意义（P〈0.05）;观察组麻醉诱导后的舒张压、收缩压低于对照组（P〈0.05）,心率稍高于对照组。结论瑞芬太尼应用于腹腔镜下胆囊切除术,可保证患者血流动力学平稳,有效提高麻醉效果,但其加快患者心率,在临床中应根据患者实际情况应用。Objective To explore the feasibility and safety of remifentanil applying to laparoscopic cholecystectomy.Methods From December 2013 to December 2014,70 patients undergone laparoscopic cholecystectomy in our hospital were selected,and they were randomly divided into observation group and control group.In the control group,remifentanil was selected for anesthetization,while in the observation group,fentanyl was applied.The clinical anesthetic effect between two groups was compared and observed.Results In the observation group,the postoperative recovery of spontaneous breathing time was（2.7±0.4）min,awakening time（7.1±1.6）min,extubation time was（7.8±1.7）min,time of orientation recovery was（9.4±2.5）min,the indexes in the observation group was superior to that in the control group respectively,with statistical differences（P0.05）.In the observation group,the immediate state,1 h state,and 3 h state after extubation was better than that in the control group respectively,with statistical differences（P0.05）.The diastolic blood pressure,systolic blood pressure was lower than that of observation group respectively,with statistical differences（P 0.05）,and heart rate was higher than that of control group.Conclusion For patients accepting laparoscopic cholecystectomy,application of remifentanil for anesthesia can ensure stable haemodynamics and improve the anesthetic effect,but remifentanil applying to the clinic may accelerate patient′s heart rate,which should be considered and its clinical application should be in accordance with the actual situation of the patients.

关 键 词：瑞芬太尼 腹腔镜下胆囊切除术 麻醉效果 

分 类 号：R614.1[医药卫生—麻醉学]