依托咪酯乳剂复合舒芬太尼持续泵注在腹腔镜胆囊切除术中的应用

目的:探讨依托咪酯乳剂复合舒芬太尼持续泵注在腹腔镜胆囊切除术(LC)中应用的可行性。方法:50例ASAⅠ~Ⅱ级择期在全麻下行LC患者,随机分为观察组(E组)25例,对照组(P组)25例。E组采用依托咪酯乳剂0.6~0.9 mg·kg-1·h-1复合舒芬太尼0.2μg.kg-1·h-1持续泵注,P组采用丙泊酚4~6 mg·kg-1·h-1复合舒芬太尼0.2μg.kg-1·h-1持续泵注,2组均持续输注罗库溴铵5~6μg.kg-1·min-1。记录麻醉诱导前(T₀)、麻醉诱导后即刻(T₁)、气管插管时(T₂)、气腹5 min(T₃)、气腹15 min(T₄)、解除气腹后5 min(T₅)各时点的心率、收缩压、舒张压、术后拔管时间、术后意识状态恢复情况、离开麻醉后监控室时间,观察术后躁动、恶心呕吐、呛咳、喉痉挛、术中知晓等不良反应发生情况。结果:除2组HR在T₄和T₅差异有统计学意义(P<0.01)外,其余2组间各时点血液动力学指标差异均无统计学意义(P>0.05),拔管时间、意识状态恢复情况2组差异均无统计学意义(P>0.05)。结论:依托咪酯乳剂复合舒芬太尼可安全地用于LC麻醉。

The application of etomidate emulsions combined with sufentanil continued infusion in laparoscopic cholecystectomy

Objective：To explore the application feasibility of etomidate emulsions combined with sufentanil continue pumping in laparoscopic cholecystectomy（LC）.Methods：Fifty patients in ASA Ⅰ-Ⅱ who undergone elective LC were randomly divided into trial group（E group,n=25） and control group（P group,n=25）.The patients in E group were pumped continuously with etomidate emulsions 0.6-0.9 mg·kg-1·h-1 combined with sufentanil 0.2 μg·kg-1·h-1.The patients in P group were pumped continuously with propofol 4-6 mg·kg-1·h-1 combined with sufentanil 0.2 μg·kg-1·h-1.All patients in these two groups were continuous infused with rocuronium 5-6 μg·kg-1·min-1.Heart rate（HR）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,postoperative decannulation time,postoperative recovery condition,state of consciousness post anesthesia care unit leave time,restlessness,postoperative nausea and vomiting,cough,laryngospasm,choking intraoperative awareness as adverse reaction conditions were recorded before narcotic induction narcotic induction（T0）,immediately（T1）,during tracheal intubation（T2）,gasless 5 min（T3）,15 min（T4）,after the lift gasless 5 min（T5）.Results：The hemodynamics indexes at all time points between the two groups were no statistical significance.The detubation time,consciousness recovery and the incidence rate of adverse reactions between these two groups were no statistical significance.Conclusions：Etomidate emulsions sufentanil compound can be used safely in LC anesthesia.