丙泊酚复合瑞芬太尼麻醉维持对腹部手术患者的临床疗效

目的探讨腹部手术患者应用丙泊酚复合瑞芬太尼麻醉维持的临床效果。方法选择我院2010年10月至2012年1月行腹部手术患者86例分为观察组(n=43)和对照组(n=43),对照组麻醉诱导后吸入异氟醚,芬太尼静脉注射麻醉维持;观察组麻醉诱导后以丙泊酚复合瑞芬太尼持续静脉泵入麻醉维持。观察比较两组患者者插管前、插管后5min、10min时的收缩压(SPB)、舒张压(DPB)、心率(HR)的变化,自主呼吸恢复时间、苏醒时间及术后不良反应。结果观察组气管插管前后各时间点的SPB、DPB、HR比较,差异无统计学意义(P>0.05);对照组患者气管插管后血压升高、心率增快,插管前后SPB、DPB、HR比较差异有统计学意义(P<0.05);观察组患者气管插管后SPB、DPB、HR在各时点与对照组比较,差异有统计学意义(P<0.05)观察组自主呼吸恢复时间、苏醒时间显著短于对照组,两组比较差异有统计学意义(P<0.05);两组术后不良反应发生率比较差异无统计学意义(P>0.05)。结论腹部手术应用丙泊酚复合瑞芬太尼麻醉维持术中血流动力学稳定,术后清醒快,是腹部手术安全有效的麻醉方法。

Clinical Effect of Anesthesia with Propofol Combined with Remifentanil in Patients Undergoing Abdominal Surgery

Objective To explore the effect of propofol combined with remifentanil anesthesia in patients undergoing abdominal surgery.Methods Eight six patients conducted with abdominal surgery from Oct.2010 to Jan.2011 were selected and were randomly divided into observation group and control group,with 43 cases in each group.The anesthesia induction was the same in the two groups.Then,the control group was treated with isoflurane inhalation,fentanyl intravenous injection during maintenance of anesthesia.The observation group was treated with propofol combined with remifentanil by continuous infusion during maintenance of anesthesia.The systolic blood pressure（SPB）,diastolic blood pressure（DPB）,heart rate（HR）,spontaneous breathing recovery time,palinesthesia time and postoperative adverse reactionos were observed before intubation,and at 5 min after intubation and 10 min after intubation.Results There was no significant difference of the blood pressure and heart rate in the observation group before and after intubation（P0.05）.The blood pressure and heart rate were significantly higher after tracheal intubation than those before intubation in the control group（P0.05）.The blood pressure and heart rate were significantly higher in the observation group than those in the control group at time point after intubation（P0.05）.The breathing recovery time and palinesthesia time was significant shorter of the observation group than that of the control group（P0.05）.There was no significant difference of the adverse reactions between the two groups（P0.05）.Conclusion Anesthesia with propofol combined with remifentanil can maintain stable hemodynamics in the surgery with shorter wake time,which is a safe.and effective anesthesia method for abdominal surgery.