瑞芬太尼复合丙泊酚靶控输注在妇科腹腔镜手术麻醉中的应用效果观察

目的:观察瑞芬太尼复合丙泊酚靶控输注在妇科腹腔镜手术麻醉中的应用效果。方法:选择行腹腔镜手术的妇科患者96例,按照随机数字表法均分为对照组和观察组。对照组患者采取瑞芬太尼联合七氟醚静吸复合麻醉,观察组患者采取瑞芬太尼复合丙泊酚靶控输注麻醉。比较两组患者麻醉苏醒与恢复情况及血流动力学指标变化,并观察不良反应发生情况。结果:观察组患者术后睁眼时间、拔管时间及定向力恢复时间均较对照组显著减少,组间比较差异均有统计学意义(P<0.05);观察组患者各时间点心率(HR)、平均动脉压(MAP)、血氧饱和度(Sp O2)与本组麻醉前(T0)比较差异均无统计学意义(P>0.05),而对照组患者插管后1 min(T1)、气腹后15 min(T2)的HR、MAP均较本组T0和观察组同时间点显著增加,组内及组间比较差异均有统计学意义(P<0.05)。观察组患者不良反应发生率显著低于对照组,组间比较差异有统计学意义(P<0.05)。结论:瑞芬太尼复合丙泊酚靶控输注用于妇科腹腔镜手术麻醉效果较好,术后苏醒迅速、恢复快,且可维持稳定的血流动力学,同时安全性亦较好。

Effect of Target Controlled Infusion of Remifentanil Combined with Propofol on Anesthesia of Gynecological Laparoscopic Operation

OBJECTIVE：To observe the effect of target controlled infusion of remifentanil combined with propofol on anesthesia of gynecological laparoscopic operation. METHODS： 96 patients underwent elective gynecological laparoscopic operation were randomly divided into control group and observation group. Control group received intravenous and inhalation anesthetics of remifentanil combined with sevoflurane;observation group was given target controlled infusion of remifentanil combined with propofol.The changes of anesthesia recovery and hemodynamics index were compared between 2 group,and the occurrence of ADR was observed. RESULTS：The open eyes time,extubation time and orientation recovery time of observation group were significantly reduced,compared with control group;there was no statistical significance（P〈0.05）. There was no statistical significance in HR,MAP and SpO2 of observation group between before anesthesia（T0）and other different time points（P〉0.05）. HR and MAP of control group were significantly increased at 1 min after intubation（T1）and 15 min after pneumoperitoneum（T2）,compared with at T0 and those of observation at different time points;there was statistical significance（P〈0.05）. The incidence of ADR in observation group was significantly lower than in control group;there was statistical significance（P〈0.05）. CONCLUSIONS：The target controlled infusion of remifentanil combined with propofol has a good effect in anesthesia of gynecological laparoscopic operation, and can maintain the stability of hemodynamics,with quick consciousness recovery after the surgery and good safety.