腹腔镜手术瑞芬太尼与丙泊酚靶控输注全凭静脉麻醉的临床应用

目的：评价丙泊酚和瑞芬太尼靶控输注全凭静脉麻醉在腹腔镜手术临床应用的可行性。方法：分析82例患者的临床资料。观察麻醉诱导和气管插管时的血压、心率以及术毕停药后患者自主呼吸恢复时间、呼之睁眼时间、拔管时间、定向力恢复时间和离开手术室时间。结果：麻醉诱导时收缩压由诱导前的（142±25）mmHg降至（103±21）mmHg,平均动脉压由（99±18）mmHg降至（65±15）mmHg,心率由（78±16）次/min降至（65±14）次/min,插管前后血压和心率无显著变化,无一例有插管反应。术毕停药后患者自主呼吸恢复时间为（13±6）min,呼之睁眼时间（9±5）min,拔管时间（14±7）min,定向力恢复时间（15±6）min,离开手术室时间（21±9）min。结论：瑞芬太尼与丙泊酚靶控输注全凭静脉麻醉用于腹腔镜手术时,麻醉诱导平稳,术中血流动力学稳定,术后恢复迅速。

Clinical application of target-controlled infusion of remifentanil and propofol during laparoscopic surgery

Objective:To evaluate the clinical feasibility of target-controlled infusion-based anesthesia using remifentanil and propofol.Methods:The clinical data of 82 cases was analyzed.The hemodynamic during induction of anesthesia and recovery index were recorded.Results:Systolic blood pressure(SBP)decreased from(142±25)mm Hg before induction of anesthesia to(103±21)mm Hg(P< 0.05)after induction,mean blood pressure(MBP)decreased from(99±18)mm Hg to(65±15)mm Hg(P<0.05)and heart rate(HR)decreased from(78±16)beats/min to(65±14)beats/min(P>0.05).No patient showed hemodynamic stress to tracheal intubation.Time from stopping administration of anestheticr to full spontaneous respiration,eye opening,tracheal extubation,orientation recovery and discharging from the operating room was(13±6),(9±5),(14±7),(15±6)and(21±9)minutes respectively.Conclusions:Remifentanil/propofol TCI-based anesthesia in iaparoscopic surgery achieved the optimal hemodynamic stability during anesthesia induction and maintenance,and better recovery index from anesthesia.