瑞芬太尼复合丙泊酚在腹腔镜手术麻醉中的应用

目的 观察瑞芬太尼联合丙泊酚在腹腔镜手术麻醉中的应用效果。方法 选择2017年8月~2018年8月我院收治的84例腹腔镜胆囊切除术患者作为研究对象，按随机数字表法分为观察组和对照组，各42例。对照组患者术中采用芬太尼联合丙泊酚进行麻醉诱导和维持，观察组患者术中采用瑞芬太尼联合丙泊酚进行麻醉诱导和维持，观察两组患者麻醉起效时间、苏醒时间、麻醉恢复时间以及镇痛药使用时间；比较入室时（T0）、麻醉诱导后（T1）、气管插管后1 min（T2）、气腹15 min（T3）以及拔管时（T4）两组患者心率（HR）及平均动脉压（MAP）水平；记录两组不良反应情况。结果 观察组麻醉起效时间、苏醒时间、麻醉恢复时间以及镇痛药使用时间分别为（1.44±0.28）min、（5.83±1.59）min、（19.52±5.36）min以及（22.34±2.92）min，均少于对照组的（3.21±0.63）min、（14.48±2.35）min、（38.92±4.57）min以及（48.22±3.74）min，差异有统计学意义（P＜0.05）；T0~T4时两组HR水平比较，差异无统计学意义（P＞0.05）；T0、T1以及T4时两组MAP水平比较，差异无统计学意义（P＞0.05）；T2、T3时观察组MAP水平低于对照组，差异有统计学意义（P＜0.05）；观察组不良反应发生率为7.14%，低于对照组的11.90%，但差异无统计学意义（P＞0.05）。结论 瑞芬太尼联合丙泊酚在腹腔镜手术麻醉中效果较好，对血流动力影响小，麻醉起效、恢复更快，安全可靠。

Application of Remifentanil Combined with Propofol in Laparoscopic Anesthesia

Abstract:Objective To observe the effect of remifentanil combined with propofol in laparoscopic anesthesia.Methods 84 patients with laparoscopic cholecystectomy admitted to our hospital from August 2017 to August 2018 were enrolled in the study. They were divided into observation group and control group according to the random number table method, 42 cases each. In the control group, fentanyl combined with propofol was used for induction and maintenance of anesthesia. Patients in the observation group were treated with remifentanil and propofol for induction and maintenance of anesthesia. The onset time and recovery time of the two groups were observed. The time of anesthesia recovery and the time of analgesic use were compared; when entering the room (T0), after anesthesia induction (T1), 1 min after tracheal intubation (T2), pneumoperitoneum 15 min (T3), and extubation (T4) Heart rate (HR) and mean arterial pressure (MAP) levels were recorded in the group; adverse events were recorded in both groups.Results The anesthesia onset time, recovery time, anesthesia recovery time and analgesic use time of the observation group were (1.44±0.28) min, (5.83±1.59) min, (19.52±5.36) min and (22.34±2.92) min, respectively, all were less than (3.21±0.63) min, (14.48±2.35) min, (38.92±4.57) min and (48.22±3.74) min in the control group, the difference was statistically significant (P<0.05); There was no significant difference in HR levels between the two groups at T0-T4 (P>0.05). There was no significant difference in MAP between the two groups at T0, T1 and T4 (P>0.05). The observation group at T2 and T3 the MAP level was lower than that of the control group,the difference was statistically significant (P<0.05). The incidence of adverse reactions in the observation group was 7.14%, which was lower than that in the control group 11.90%, but the difference was not statistically significant (P>0.05).Conclusion Remifentanil combined with propofol is effective in laparoscopic anesthesia, has little effect on blood flow, anesthesia is effective; recovery is faster, safe and reliable.