瑞芬太尼复合丙泊酚麻醉在腹腔镜胆囊切除术中的应用  

The Application of Remifentanil combined with Propofol in Laparoscopic Cholecystectomy

作　　者：胡秀琴[1] 李宝金[1] 徐敏[1] 洗少兰 HU Xiu-qin;LI Bao-jin;XU Min;XIAN Shao-lan(The Eighth People's Hospital of Guangzhou,Guangzhou 510060,China)

机构地区：[1]广州市第八人民医院,广东广州510060

出　　处：《中国医药指南》2018年第21期9-10,共2页Guide of China Medicine

摘　　要：目的探讨瑞芬太尼复合丙泊酚麻醉在腹腔镜胆囊切除术中的应用效果。方法选取我院2016年7月至2018年1月收治的腹腔镜胆囊切除术患者90例作为研究对象,按照摸球法的分组方法分为对照组(n=45)和实验组(n=45),对照组选择芬太尼复合丙泊酚、阿曲库铵的方法进行静脉麻醉,实验组选择瑞芬太尼复合丙泊酚、阿曲库铵的方法进行静脉麻醉,比较两组血流动力学变化、镇痛效果、安全性及术后恢复情况。结果两组术前HR、DBP、SBP进行比较,组间无显著差异(P>0.05);气腹后和术后进行比较,实验组均低于对照组(P<0.05);实验组拔管后5 min、10 min的OAA/S评分均高于对照组,两组差异明显(P<0.05);在不良反应发生率比较上,实验组明显低于对照组,差异存在统计学意义(P<0.05);对照组自主呼吸恢复时间、拔管时间、睁眼时间均长于实验组,组间具有显著性差异(P<0.05)。结论腹腔镜胆囊切除术中应用瑞芬太尼复合丙泊酚麻醉效果显著,可维持血流动力学稳定,安全可靠,术后恢复快,具有积极的临床采纳和推广价值。Objective To investigate the effect of remifentanil combined with propofol in laparoscopic cholecystectomy.Methods Laparoscopic cholecystectomy in our hospital from July 2016 to January 2018 were treated with excision of 90 cases as the research object,according to the grouping method of touch ball method was divided into control group(n=45)and experimental group(n=45),the control group selection method of fentanyl combined with propofol,atracurium intravenous anesthesia,the experimental group selection method of remifentanil propofol,atracurium intravenous anesthesia,the recovery of hemodynamic changes were compared between the two groups,analgesic effect,safety and postoperative.Results The two groups preoperative HR,DBP,SBP were compared,no significant difference between groups(P>0.05);after pneumoperitoneum and postoperative were compared,the experimental group were lower than the control group(P<0.05);the experimental group 5 min after extubation,10 min OAA/S scores were higher than the control group,the difference between the two groups obviously(P<0.05);the rate of adverse reactions occurred in the comparison,the experimental group was significantly lower than the control group,the difference was statistically significant(P<0.05);the control group of spontaneous breathing recovery time and extubation time,waking time were longer than the experimental group,with a significant difference between the groups(P<0.05).Conclusion The application of remifentanil combined with propofol in laparoscopic cholecystectomy is effective,and it can maintain hemodynamic stability,safe and reliable,and recover quickly after operation.It has a positive clinical value of adoption and promotion.

关 键 词：腹腔镜胆囊切除术 丙泊酚 瑞芬太尼 

分 类 号：R657.4[医药卫生—外科学]