全凭静脉气管插管全身麻醉在腹腔镜胆囊切除术的临床研究

目的:探讨异丙酚、瑞芬太尼、万可松复合全凭静脉气管插管全身麻醉在腹腔镜胆囊切除术(LC)的临床应用。方法:50例LC患者全部采用异丙酚、瑞芬太尼、万可松复合全凭静脉气管插管全身麻醉。监测麻醉前、诱导后、插管后3min、气腹后10min、拔管前1min、拔管后3min的HR、MAP、SpO2变化,记录患者麻醉后清醒时间以及麻醉中知晓情况。结果:13例患者表现出较明显的心率减慢及血压下降,与透导前有显著改变(P<0.05),气管插管3min后心率、血压多能自动恢复正常,所有患者麻醉维护过程中HR、MAP、SpO2无显著变化(P>0.05)。麻醉后3min内36例(70％)完全清醒,5min内所有患者完全清醒。术后1例(2％)诉术中轻度知晓(P>0.05)。结论:异丙酚、瑞芬太尼、万可松复合全凭静脉气管插管全身麻醉对于LC来说是一种安全、有效、可靠的麻醉方法。

The study of the application of complete intravernous anesthesia under endotracheal intubation to laparoscopic cholecystectomy

Objective: In this study we discuss the application of propofol,remifentanyl,and vecuronium to the la-paroscopic cholecystectomy, combined with complete intravenous anesthesia under endotracheal intubation. Methods: Propofol, remifentanyl, and vecuronium, combined with complete intravenous anesthesia under endotracheal intubation were administered to 50 cases subjected to laparoscopic cholecystectomy. Each patient' s changes in HR, MAP and SpO2 were respectively measured before anesthesia,after anesthetic induction,3 minutes after endotracheal intubation, 10 minutes after pneumoperitoneum, 1 minute before endotracheal extubation and 3 minutes after endotracheal extubation. And each patient's time to regain consciousness and awareness state in anesthesia were also recorded. Results: Remarkable drops in HR and BP were present in 13 cases with significant difference(P< 0.05)from those before anesthetic induction,automatically restoring to normal 3 minutes after endotracheal intubation. All patients went through anesthetic maintenance duration without apparent changes in HR,MAP and SpO2(P>0.05) ,with 35 cases 3 minutes after operation and 50 cases 5 minutes after operation regaining complete consciousness, and 1 case having awareness during operation. Conclusions: The application of propofol, remifentanyl and vecuronium is reliable, safe and effective to the laparoscopic cholecystectomy, combined with complete intravenous anesthesia under endotracheal intubation.