摘要
目的探讨瑞芬太尼复合丙泊酚用于腹腔镜胆囊切除术的麻醉效果。方法选取2013年5月至2014年5月华北石油二部医院收治的120例需行腹腔镜胆囊切除术患者为研究对象,完全随机分为瑞芬太尼组和芬太尼组,各60例。瑞芬太尼组给予瑞芬太尼复合丙泊酚麻醉,芬太尼组给予芬太尼复合丙泊酚麻醉,对比两组患者的麻醉效果。结果瑞芬太尼组与芬太尼组的收缩压、舒张压及心率在术前和术毕的组内及组间比较,差异无统计学意义(P>0.05),但是在气腹后瑞芬太尼组的收缩压、舒张压及心率显著低于芬太尼组,差异有统计学意义(P<0.05)。瑞芬太尼组的意识恢复时间为(7.9±2.2)min,拔管时间为(14.8±2.8)min,止痛时间为(16.9±2.5)min,显著低于芬太尼组的意识恢复时间(11.3±2.1)min,拔管时间(18.9±2.4)min,止痛时间(23.2±3.1)min(P<0.01);瑞芬太尼组的综合VAS评分为(1.8±1.0)分,芬太尼组为(4.3±1.1)分,瑞芬太尼组显著低于芬太尼组,差异有统计学意义(P<0.01)。术后24 h不良反应主要包括恶心呕吐、呼吸抑制、嗜睡及苏醒后躁动,瑞芬太尼组总不良反应发生率低于芬太尼组[3.3%(2/60)比23.3%(14/60)],差异有统计学意义(P<0.05);瑞芬太尼组无呼吸抑制及躁动情况发生,而芬太尼组呼吸抑制发生率为3.4%,躁动率为5.1%,两组比较差异有统计学意义(P<0.05)。结论瑞芬太尼复合丙泊酚用于腹腔镜胆囊切除术的麻醉效果好,安全性高,值得临床应用。
Objective To investigate the anesthesia effect of remifentanil combined with propofol for laparoscopic cholecystectomy. Methods During May 2013 and May 2014 in Huabei Oilfield Division Two Hospital 120 cases of laparoscopic cholecystectomy were included in the study,and randomly divided into observation group and fentangl group： the remifentanil group received remifentanil plus propofol anesthesia,while the fentangl group received fentanyl and propofol anesthesia,and the anesthetic effect of the two groups were compared. Results Systolic blood pressure,diastolic blood pressure and heart rate before and after surgery and between the two groups had no statistically significant difference（ P 〉0. 05）,but systolic blood pressure,diastolic blood pressure and heart rate after pneumoperitoneum in the remifentanil group were statistically significantly lower than the fentangl group（ P 〈0. 05）. In the remifentanil group consciousness recovery time was（ 7. 9 ± 2. 2） min,extubation time was（ 14. 8 ± 2. 8） min,analgesic time was（ 16. 9 ± 2. 5）min,significantly lower than the fentangl group＇s（ 11. 3 ± 2. 1） min,（ 18. 9 ± 2. 4） min,（ 23. 2 ± 3. 1） min respectively（ P 〈0. 01）; the integrated VAS score of he the remifentanil group was（ 1. 8 ± 1. 0）,of the fentangl group was（ 4. 3 ± 1. 1）,the difference was statistically significant（ P 〈0. 01）. The 24 h postoperative adverse reactions included nausea,vomiting,respiratory depression,lethargy,and restlessness after waking,total adverse renction rate of the remifentanil group was lower than the fentangl group [3. 3%（ 2 /60） vs23. 3%（ 14 /60） ],the difference was satistically significant（ P 〈0. 05）; there was no breathing depression and restlessness in the remifentanil group,while in the fentangl group was 3. 4% and 5. 1% respectively,the differences were statistically significant（ P 〈0. 05）. Conclusion The anesthetic effect of remifentanil and propofol for laparoscopic cholecystectomy is good,with high safety,thus is worthy of clinical application.
出处
《医学综述》
2015年第18期3449-3451,共3页
Medical Recapitulate
