妇科腹腔镜手术中异丙酚联合瑞芬太尼静脉全麻与腰硬膜外麻醉的效果比较

目的：比较异丙酚联合瑞芬太尼静脉全麻与腰硬膜外麻醉在妇科腹腔镜手术中的麻醉效果，及二者的安全性与可行性。方法将70例即将行妇科腹腔镜手术的患者随机分为两组：A组35例，采用异丙酚联合瑞芬太尼静脉全麻；B组35例，采用腰硬膜外麻醉。结果A组麻醉效果、疼痛反应、肌松度、内脏牵拉反应均优于B组（P〈0.05或P〈0.01）；A组的SBP、DBP、MAP、HR、SpO2与B组比较无显著性差异；A组术中流入量、麻黄素使用例数、术后发生恶心呕吐的例数均少于B组（P〈0.01）。结论在妇科腹腔镜手术麻醉中，异丙酚联合瑞芬太尼静脉全麻的效果优于腰硬膜外麻醉，易行、安全性更高。

Comparision of intravenous anesthesia and lumbar epidural anesthesia using rayleigh fentanyl-propofol and spinal epidural anesthesia in gyne-cology department periyoneoscope surgery

Objective To investigate anesthesia effect comparision of the Rayleigh fentanyl-propofol intravenous anes-thesia and epidural anesthesia and analyze the safety and feasibility of them. Methods A total of 70 cases of the pa-tients undergoing laparoscopic surgery were randomly divided into A,B groups, 35 cases in each group, group A used Rayleigh fentanyl-propofol intravenous anesthesia and group B used lumbar epidural anesthesia. Results Narcotic ef-fect, pain, muscle relaxant and internal force of group A were better than that of group B （P〈0.05, P〈0.01）; There were no significant difference of SBP, DBP, MAP, HR, SpO2 between group A and group B; Intraoperative inflow,inci-dence of postoperative nausea and vomiting and the use of ephedrine in group A were less than group B（P〈0.01）. Con-clusion In gynecological laparoscopic surgery anesthesia, the effect of Rayleigh fentanyl-propofol intravenous anesthe-sia,which is easy and security, is better than that of lumbar epidural anesthesia.