丙泊酚复合瑞芬太尼靶控静脉麻醉与静吸复合麻醉的比较  

Comparison of propofol and remifentanil target-controlled intravenous anesthesia and intravenous-inhalation combined anesthesia

作　　者：高国一 杨臻 李忠云 曾毅 GAO Guo-yi, YANG Zhen, LI Zhong-yun, et al.(Department of Anesthesia, Yunnan People＇ s Hospital of Xishuangbanna Dai Autonomous Prefecture, Jinghong 666100, Chin)

机构地区：[1]云南省西双版纳傣族自治州人民医院麻醉科,666100

出　　处：《中国实用医药》2018年第7期6-8,共3页China Practical Medicine

摘　　要：目的评价丙泊酚复合瑞芬太尼靶控静脉麻醉与静吸复合麻醉对择期行腹腔镜胆囊切除手术患者的效果。方法 150例择期行腹腔镜胆囊切除手术患者,随机分为丙泊酚-瑞芬太尼靶控组(B组)和静吸复合麻醉组(C组),每组75例。观察两组的麻醉效果。结果 C组麻醉诱导时最低舒张压(DBP)、平均动脉压(MAP)低于B组,收缩压(SBP)<90 mm Hg(1 mm Hg=0.133 k Pa)例数多于B组,心率(HR)<50次/min例数少于B组,插管反应发生率高于B组,差异具有统计学意义(P<0.05);B组术中使用阿托品发生率为16.0%,高于C组的5.3%,差异具有统计学意义(P<0.05)。两组患者术后自主呼吸恢复时间、睁眼时间、拔管时间比较差异无统计学意义(P>0.05);B组定向力恢复时间、离开麻醉恢复室(PACU)时间早于C组,差异具有统计学意义(P<0.05);C组术后恶心发生率高于B组,差异具有统计学意义(P<0.05);两组呕吐发生率比较差异无统计学意义(P>0.05)。术后24 h随访,两组患者均无术中知晓。B组满意度为94.7%(71/75),C组满意度为93.3%(70/75),比较差异无统计学意义(P>0.05)。结论与常规静吸复合麻醉相比,丙泊酚复合瑞芬太尼靶控静脉麻醉诱导更加平稳,苏醒质量更优良,恶心发生率降低。Objective To evaluate the effect of propofol and remifentanil target-controlled intravenous anesthesia and intravenous-inhalation combined anesthesia on patients undergoing elective laparoscopic cholecystectomy.Methods A total of 150 patients undergoing elective laparoscopic cholecystectomy were randomly divided into propofol-remifentanil target-controlled group（group B） and intravenous-inhalation combined anesthesia group（group C）,with 75 cases in each group.The anesthesia effect in two groups was observed.Results Group C had lower minimum diastolic blood pressure（DBP） and mean arterial pressure（MAP） at anesthesia induction than group B,more cases of systolic blood pressure（SBP） 90 mm Hg（1 mm Hg=0.133 kPa） than group B,less cases of heart rate（HR）50 times/min than group B,and higher incidence of intubation reaction than group B.Their difference was statistically significant（P〈0.05）.Group B had higher of intraoperative atropine using rate as 16.0% than 5.3% in group C,and the difference was statistically significant（P〈0.05）.Both groups had no statistically significant difference in postoperative spontaneous breathing recovery time,eyes open time,extubation time（P〈0.05）.Group B had earlier directional force recovery time and post-anesthesia care unit（PACU） time than group C,and the difference was statistically significant（P〈0.05）.Group C had higher incidence of postoperative nausea than group B,and the difference was statistically significant（P〈0.05）.Both groups had no statistically significant difference in incidence of vomiting（P〈0.05）.During postoperative 24 h follow-up,there was no intraoperative awareness in the two groups.Group B had satisfaction as 94.7%（71/75）,which was 93.3%（70/75） in group C,but the difference was not statistically significant（P〈0.05）.Conclusion Compared with conventional intravenous-inhalation combined anesthesia,propofol and remifentanil target-controlled intravenous anesthesia is more stable,the quality

关 键 词：丙泊酚 瑞芬太尼 靶控输注 静脉麻醉 

分 类 号：R614[医药卫生—麻醉学]