舒芬太尼联合瑞芬太尼在腹腔镜胆囊手术中的应用

目的：观察舒芬太尼诱导，瑞芬太尼维持应用于腹腔镜胆囊切除术中的临床效果。方法：ASAⅠ～Ⅱ级择期行腹腔镜胆囊切除手术的病人60例，随机分为瑞芬太尼组（R组）和舒芬太尼-瑞芬太尼组（SR组），每组30例。麻醉诱导分别采用瑞芬太尼1μg／kg、舒芬太尼O．5μg／kg，麻醉维持两组均为瑞芬太尼0．1μg／kg／min和异丙酚4—6mg／kg／h。比较两组的麻醉效果和术后恢复情况及不良反应等。结果：R组与SF组气管插管和术中均能维持良好的血流动力学；苏醒期SR组血流动力学稳定，VRS和躁动均低于R组（P〈0．05）。结论：舒芬太尼诱导复合瑞芬太尼持续静脉输注维持麻醉方式适宜腹腔镜胆囊切除手术，能满足手术麻醉深度，保证围术期血流动力学稳定，术后又能迅速恢复并可减轻瑞芬太尼麻醉术后的急性疼痛。

The Application of Sufentanil Combined with Remifentanil for Patients in Laparoscopic Cholecystectomy

Objective To investigate the advantages of sufentanil combined with fentnyl in laparoscopic cholecystectomy. Methods Sixty ASA grade Ⅰ-Ⅱ patients, scheduled for laparoscopic cholecystectomy under general anesthesia were randomly divided into remifentanil group （R, n=30） and sufentanil-remifentanil grorp （SR, n=30）. Group R were given remifentanil 1μ g/kg in anesthesia induction and maintained with 0.1μg/kg/min; Group SR were given sufentanil 0.5μ g/kg in anesthesia induction and maintained with remifentanil 0.1μg/kg/min. The changes of SBP and HR were observed during anesthesia. The recovery of spontaneous breathing time, waking time, extubation time and complication related to recocery and extubation were recorded. VAS and agitation emergence score were measured during postoperation. Result Both two groups had good hemodynamic stability during anesthesia induction and operative procedure. Group SR had lower VAS score and lower agitation score compared to group R postoperatively （P〈0.05）. Conclusion Sufentanil for anesthesia induction and Remifentanil for anesthesia maintaining had good hemodynamic stability during introperative procedure and had better postoperative recovery quality for patients undergoing laparoscopic cholecystectomy.