丙泊酚复合瑞芬太尼喉罩全麻的效果分析与研究

目的 探讨丙泊酚复合瑞芬太尼喉罩全身麻醉(全麻)的效果。方法 62例腹腔镜、泌尿科、骨科、肛肠科、妇科等手术治疗的患者,随机分为实验组和对照组,每组31例。对照组采用常规气管插管静脉复合全麻,实验组给予靶控输注丙泊酚复合瑞芬太尼喉罩全麻。比较两组患者插入喉罩(插管)、插管1 min、插管3 min、拔出喉罩(拔管)1 min、拔管3 min时心率(HR)和平均动脉压(MAP)水平;不良反应发生情况、麻醉效果;全麻起效时间、维持全麻时间、术后苏醒时间。结果 实验组插管时、插管1 min、插管3 min、拔管1 min、拔管3 min的HR水平分别为(77.52±6.36)、(73.26±5.56)、(72.01±4.69)、(75.35±7.63)、(72.34±6.79)次/min,均低于对照组的(92.34±7.85)、(87.97±5.25)、(78.85±5.20)、(95.69±9.21)、(85.63±7.43)次/min,差异均具有统计学意义(P<0.05)。实验组插管时、插管1 min、插管3 min、拔管1 min、拔管3 min的MAP水平分别为(90.25±6.73)、(87.65±7.98)、(88.79±7.65)、(88.09±5.61)、(88.52±5.16)mm Hg(1 mm Hg=0.133 kPa),均低于对照组的(109.51±7.85)、(103.27±12.43)、(102.52±8.21)、(106.74±7.68)、(104.62±7.71)mm Hg,差异均具有统计学意义(P<0.05)。实验组不良反应发生率3.23%低于对照组的19.35%,差异具有统计学意义(P<0.05)。实验组麻醉总有效率96.77%均高于对照组的80.65%,差异均具有统计学意义(P<0.05)。实验组全麻起效、维持全麻、术后苏醒时间分别为(1.61±0.23)、(100.59±6.72)、(17.99±3.52)min,均短于对照组的(2.93±0.41)、(123.61±7.85)、(36.87±4.16)min,差异均具有统计学意义(P<0.05)。结论 针对腹腔镜等手术患者应用丙泊酚复合瑞芬太尼喉罩全麻对血液动力学影响小,不良反应发生率低,麻醉效果良好,降低对机体损伤,值得推广应用。

Analysis and study on the effect of laryngeal mask general anesthesia with propofol and remifentanil

Objective To discuss the effect of laryngeal mask general anesthesia with propofol and remifentanil.Methods A total of 62 patients with laparoscopic,urological,orthopedic,anorectal,gynecological and other surgical treatment were randomly divided into experimental group and control group,with 31 cases in each group.The control group received conventional endotracheal intubation combined with general anesthesia,and the experimental group received propofol and remifentanil target-controlled infusion for general anesthesia.The heart rate(HR)and mean arterial pressure(MAP)level immediately after intubation,1 min after intubation,3 min after intubation,1 min after extubation and 3 min after extubation,occurrence of adverse reactions,onset time of general anesthesia,duration of general anesthesia and postoperative recovery time were compared between the two groups.Results HR level of the experimental group immediately after intubation,1 min after intubation,3 min after intubation,1 min after extubation and 3 min after extubation were(77.52±6.36),(73.26±5.56),(72.01±4.69),(75.35±7.63)and(72.34±6.79)times/min respectively,which were all lower than those of the control group(92.34±7.85),(87.97±5.25),(78.85±5.20),(95.69±9.21)and(85.63±7.43)times/min,and the difference was statistically significant(P<0.05).MAP level of the experimental group immediately after intubation,1 min after intubation,3 min after intubation,1 min after extubation and 3 min after extubation were were 90.25±6.73),(87.65±7.98),(88.79±7.65),(88.09±5.61)and(88.52±5.16)mm Hg(1 mm Hg=0.133 kPa)respectively,which were all lower than those of the control group(109.51±7.85),(103.27±12.43),(102.52±8.21),(106.74±7.68)and(104.62±7.71)mm Hg,and the difference was statistically significant(P<0.05).The incidence of adverse reactions 3.23%of the experimental group was lower than that of the control group 19.35%,and the difference was statistically significant(P<0.05).The total effective rate of anesthesia 96.77%of the experimental group was higher than that of the control group 80.65%,and the difference was statistically significant(P<0.05).The onset time of general anesthesia,duration of general anesthesia and postoperative recovery time of the experimental group were(1.61±0.23),(100.59±6.72)and(17.99±3.52)min,which were all shorter than those of the control group(2.93±0.41),(123.61±7.85)and(36.87±4.16)min,and the difference was statistically significant(P<0.05).Conclusion Laryngeal mask general anesthesia with propofol and remifentanil for laparoscopy and other surgical patients has little effect on hemodynamics,low incidence of adverse reactions,good anesthesia effect,and reduced damage to the body.It is worth popularizing and applying.