异丙酚复合芬太尼静脉麻醉用于腹腔镜胆囊切除术的临床研究

目的:研究异丙酚芬太尼静脉麻醉在腹腔镜胆囊切除术的应用,效果,并与安氟醚吸入麻醉相比较,探索适于短效腹腔镜手术安全有效的静脉麻醉。方法:将22～78岁,ASAⅠ～Ⅱ级胆囊择期手术120例,随机分为2组,静脉组和吸入组各60例,静脉组静脉注射异丙酚1.5mg/kg,芬太尼3～5ug/kg,维库溴铵0.06～0.1mg/kg。吸入组用2.5％硫贲妥钠5mg/kg。琥珀胆碱1.5mg/kg,气管内插管持续吸入0.5％～2.5％安氟醚,取出胆囊时均使用阿托品1mg,新斯的明2mg,拮抗残余肌松作用。结果:静脉酚组患者术后苏醒迅速且完全,苏醒后较吸入组患者安静,80％患者术后2h才感觉疼痛,只有20％患者感觉疼痛,术后无需应用镇痛药。结论:异丙酸诱导后心率明显低于吸入组,但大部分患者不用处理,3～5min后恢复正常。异丙酚复合芬太尼静脉麻醉可产生良好的麻醉效应,循环维持稳定,苏醒迅速完全,术后可产生良好的镇痛效果,恶心呕吐发生率低。

The clinicd study of propofol combined with fentanyl intravenous anesthesia in laparoscopic cholecystectomy

Objective:To study and observe the anesthetic effect of propofol combined with fentanyl intravenous anesthesia in laparoscopic cholecystectomy and compared with enflurane inhalation anesthesia, to discover an intravenous anesthetic method that adapt to short-time laparoscopic cholecystectomy. Methods : 120 adult patients of 22-78 years old and ASA Ⅰ-Ⅱ grade scheduled were randomly dividedinto two groups. Anesthesia was induced with intravenous propofol 1.5mg/kg,fentanyl3 -5ug/kg and vecuronium0. 06-0.1mg/kg in group Ⅰ(n= 60)or 2.5% thiopental 5mg/kg, scoline 1. 5mg/kg and inhaled 0.5%-2. 5 % enflurane during endotracheal intubation in group Ⅱ(n = 60). Patients in two groups were used neostigmine 2mg and atropine lmg to competite the residual muscle-relaxed-effect after taken out chole-cyst. Result:The analepsia of patients in group Ⅰ were more quiet than patients in group Ⅱ,AND 80% patients were not feeling pain until postoperative 2 hours,only 20%patients were feeling pain in postopera-tion with out use analgesia medicine. Conclusion:The heart rate of the patients in group Ⅰ was obviously lower than that of the patients in group Ⅱ. Most of patients need not tackle, they would recover the order after 3-5 minutes. The intravenous anesthesia of propofol combined with fentanyl might produce a good abirritation, stable circulation and quick analepsia.