瑞芬太尼复合丙泊酚靶控输注麻醉在腹腔镜胆囊切除术中的麻醉效果观察

目的观察瑞芬太尼复合丙泊酚靶控输注在腹腔镜胆囊切除术中的麻醉效果.方法将腹腔镜胆囊切除术患者280例随机分为瑞芬太尼复合丙泊酚靶控输注组（TCI组）和异氟烷复合丙泊酚组（对照组）各140例.比较两组各时间节点血流动力学参数的变化、术毕不同时间节点的苏醒情况和镇静评分.结果与对照组比较,TCI组T1时间节点的SBP、DBP、HR差异有统计学意义（P〈0.05）;TCI组麻醉恢复的自主呼吸恢复时间、苏醒时间、拔管时间,差异有统计学意义（P〈0.01）;TCI组的5 min、10 min OAAS评分差异有统计学意义（P〈0.01）,但30 min后,两组差异无统计学意义（P〉0.05）.结论瑞芬太尼复合丙泊酚靶控输注麻醉,在麻醉诱导插管时易导致血压下降、心率减慢、术中血流动力学平稳;术毕苏醒迅速、完全,麻醉安全性高、可控性强.

Anaesthetic Effect of Remifentanil and Propofol Composite Target-controlled Infusion on Patients in Laparoscopic Cholecystectomy

Objective To observe the anaesthetic effect of remifentanil and propofol composite TCIon patients in laparoscopic cholecystectomy（LC）.Methods 280 laparoscopic cholecystectomy（LC）patients were randomly divided into 2 groups：remifentanil and propofol composite target-controlled infusion group（TCI group）and isoflurane and propofol composite target-controlled infusion（control group）,140 patients in each group.The changes in hemodynamical indexes,degree and sedation score at different time were compared between two groups.Results The SBP,DBP,and HR at T1 node time in TCI group had significant difference with the control group（P〈0.05）.The spontaneous respiration recovery time,wake up time,and tube drawing time in TCI group had significant difference with the control group（P〈0.01）.The OAAS score at 5 min and 10 min in TCI group had significant difference with the control group（P〈0.01）,but at 30min had no significant difference with the control group（P〉0.05）.Conclusions Remifentanil and propofol composite target-controlled infusion（TCI）decrease blood pressure and heart rate during anesthesia induction.However,the hemodynamics is stable during operation,patients wake up quickly and completely after operation.Therefore the anaesthetic method has high security and easy controuability.