瑞芬太尼复合七氟烷用于妇科腹腔镜手术的临床效果

目的观察瑞芬太尼复合七氟烷全麻在妇科腹腔镜手术麻醉中的诱导、维持和术后苏醒过程的效果。方法择期妇科腹腔镜手术患者60例,ASAⅠ～Ⅱ级,随机分为瑞芬太尼组(R组)和芬太尼组(F组),每组30例。记录麻醉诱导前(T0)、诱导后插管前(T1)、插管后即刻(T2)、切皮气腹时(T3)、关腹缝皮时(T4)、术毕时(T5)、拨管时(T6)的MAP和HR,记录自主呼吸恢复的时间、呼之睁眼(意识恢复)的时间、拔管时间,24h恶心、呕吐发生率以及有无术中知晓。结果与R组比,F组T1点MAP较R组降低更明显(P<0.05),T2、T3时MAP、HR升高更明显(P<0.05);R组T6点的MAP、HR升高较F组明显(P<0.05)。与F组比,R组患者术后自主呼吸恢复时间、呼之睁眼(意识恢复)时间、拔管时间明显缩短(P<0.05)。结论妇科腹腔镜手术患者,在瑞芬太尼复合七氟烷全麻下血流动力学稳定,术后苏醒快,苏醒质量高。

Effect of remifentanil-sevoflurane anesthesia on patients undergoing gynaecological surgery under laparoscopy

Objective To observe the effect of remifentanil-sevoflurane anesthesia on patients undergoing gynaecological laparoscopy surgery. Methods Sixty ASA Ⅰ~Ⅱ patients undergoing elective gynecologic laparoscopic surgery were randomly assigned into two groups (n=30): group R (treated with remifentanil and sevoflurane) and group F (treated with fentanyl and sevoflurane). The mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia induction (T0), after induction before intubation (T1), right after intubation (T2), right after pneumoperitoneum (T3), when sewing skin (T4), the end of operation (T5), and during extubation (T6), respectively. The spontaneous breathing recovery time, open eyes when calling (consciousness recovery) time, extubation time, the incidence of 24 h nausea, vomiting, and intraoperative awareness were also recorded. Results MAP was lower in group F than that in group R at T1 (P<0.05), MAP and HR were higher in group F than that in group R at T2 and T3 (P<0.05), MAP and HR increased more significantly in group R than that in group F at T6 (P<0.05). The spontaneous breathing recovery time, open eyes when calling (consciousness recovery) time, and extubation time were significantly shorter in group R than that in group F (P<0.05). Conclusion Remifentanil-sevoflurane anesthesia for gynaecological laparoscopy surgery has the advantage of rapid emergence and more stable hemodynamics.