腹腔镜胆囊切除术瑞芬太尼复合异丙酚与芬太尼复合异丙酚的麻醉效果比较

目的比较瑞芬太尼或芬太尼复合异丙酚用于腹腔镜胆囊手术麻醉的临床效果。方法将50例腹腔镜胆囊手术患者随机分为观察组、对照组各25例。观察组持续静脉泵入异丙酚和瑞芬太尼，对照组持续静脉泵入异丙酚和芬太尼，两组同时吸入1％异氟醚。观察比较患者人室后（T1）、麻醉诱导后（T2）、插管后（T3）、充气后30s（T4）、清醒时（T5）各时点血压、心率；记录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、定向力恢复时间及拔管后OAAS评分。结果对照组T2、T3、T4时的平均动脉压（MAP）均高于观察组（P〈0．05）；对照组T2时的HR高于观察组（P〈0．05），而L时的HR低于观察组（P〈0．05）。两组自主呼吸恢复时问、呼之睁眼时间、拔管时间、定向力恢复时间及拔管后OAAS评分比较差异均有显著性（P〈0．05）。结论与芬太尼复合异丙酚麻醉下行LC比较，瑞芬太尼复合异丙酚用于LC麻醉能使围术期麻醉更平稳，是一种安全、有效的快通道麻醉方法。

Comparioson of total intravenous anesthesia of remifentanil-propofol and fentanyl-propofol in laparoscopic cholecystectomy

Objective To compare the clinical effects of Remifentanil or Fentanyl combined propofol in anesthesia care of laparoscopic cholecystectomy. Methods 50 patients undergone lapamscopic cholecystectomy were divided randomly into two groups：the observe group and the control group, and each group was of 25 cases. The observe group was venous pumped Propofol and Remifentanil,while the control group was with Propofol and Fentanyl, besides, both of them breathed in 1% Isoflurane. The blood pressure and heart rate were observed during in patients with after burglary （ T1 ）, after anesthesia （ T2 ）, after trachea intubation （ T3 ）, 30 see After the inflatable （ T4 ）, Sober （ T5 ） ; the time of respihratory recovery, oriention force recovery, open eyes after calling the patients, extubating and OAAS score after extubating were recorded. Results MAP of T2,T3 ,T4 in the control group were higher than those in the observe group （ P 〈 0.05 ） ; HR of T5 in the control group were higher than those in the observe group （P 〈0.05） ,while HR of T5 were lower than the observe group（P 〈0.05）. The time of respiratory recovery, orientation force recovery, open eyes after calling the patients, extubateand OAAS score after extubate had signiticant deviation（ P 〈 0.05 ）. Conclusion Compared with Fentanyl-Propofol in LC, total intravenous anesthesia＇ of remifentan il-propofol could be more suitable in LC, it is a safe, effective and fast inductive anesthesia method.