丙泊酚复合阿芬太尼静脉麻醉对腹腔镜胆囊切除术患者的麻醉效果研究  

Anesthetic effect of propofol combined with Alfentanil intravenous anesthesia on patients undergoing laparoscopic cholecystectomy

作　　者：王钦 陈海涛[1] 刘绍正 王先锋[1] WANG Qin;CHEN Hai-tao;LIU Shao-zheng;WANG Xian-feng(Department of Anesthesiology,General Hospital of Wanbei Coal and Power Group,Suzhou 234000,Anhui,China)

机构地区：[1]皖北煤电集团总医院麻醉科,安徽宿州234000

出　　处：《川北医学院学报》2021年第10期1334-1337,共4页Journal of North Sichuan Medical College

基　　金：蚌埠医学院自然科学类项目(2020byzd360)。

摘　　要：目的:探讨丙泊酚复合阿芬太尼静脉麻醉对腹腔镜胆囊切除术(LC)患者的麻醉效果。方法:选取94例择期LC患者为研究对象,按照麻醉方式不同分为舒芬太尼组和阿芬太尼组,每组各47例。舒芬太尼组麻醉维持阶段采用丙泊酚复合舒芬太尼麻醉;阿芬太尼组采用丙泊酚复合阿芬太尼麻醉。观察两组患者气管插管即刻(T0)、术中5 min(T1)、拔管即刻(T2)和拔管后10 min(T3)的心率(HR)、平均动脉压(MAP)、血清皮质醇(Cor);比较两组患者自主呼吸恢复时间、麻醉苏醒时间及不良反应情况。结果:舒芬太尼组T2时HR、MAP和血清Cor水平较T1时升高(P<0.05);阿芬太尼组T0~T3时HR无明显变化(P>0.05),T2时MAP、血清Cor水平较T1时升高(P<0.05);两组间T0~T3时HR、MAP、血清Cor水平比较,差异无统计学意义(P>0.05)。阿芬太尼组自主呼吸恢复时间、苏醒时间短于舒芬太尼组(P<0.05)。阿芬太尼组不良反应率低于舒芬太尼组(P<0.05)。结论:LC术中采用阿芬太尼和舒芬太尼分别复合丙泊酚麻醉维持,在稳定血流动力学和减轻手术应激方面效果相当,但阿芬太尼复合丙泊酚麻醉恢复时间更短,不良反应少更轻。Objective:To investigate the anesthetic effect of propofol combined with Alfentanil intravenous anesthesia on patients undergoing laparoscopic cholecystectomy(LC).Methods:94 patients with LC were selected and divided into sufentanil group and alfentanil group according to the different anesthesia methods,with 47 cases in each group.In sufentanil group,propofol combined with sufentanil was used in anesthesia maintenance stage,alfentanil group was anesthetized with propofol combined with alfentanil.The heart rate(HR),mean arterial pressure(MAP),serum cortisol(Cor)at after endotracheal intubation(T0),5 min during operation(T1),immediately after extubation(T2)and 10 min after extubation(T3)were observed,the recovery time of spontaneous breathing,recovery time of anesthesia and adverse reactions were compared between the two groups.Results:HR,MAP and serum Cor levels at T2 in sufentanil group were significantly higher than those at T1(P<0.05).HR had no significant change from T0 to T3 in the alfentanil group(P>0.05),MAP and serum Cor levels at T2 were significantly higher than those at T1(P<0.05).There was no significant difference in HR,MAP and serum Cor between the two groups at T0~T3(P>0.05).The recovery time of spontaneous breathing and recovery time in the alfentanil group were shorter than those in the sufentanil group(P<0.05).The adverse reaction rate of alfentanil group significantly lower than that of sufentanil group(P<0.05).Conclusion:In laparoscopic cholecystectomy,propofol combined with fentanyl and sufentanil had similar effects in stabilizing hemodynamics and reducing surgical stress,but alfentanil combined with propofol has the advantages of short recovery time and less adverse reactions.

关 键 词：腹腔镜胆囊切除术 阿芬太尼 舒芬太尼 丙泊酚 血流动力学 麻醉效果 

分 类 号：R657.4[医药卫生—外科学]