瑞芬太尼复合丙泊酚在腹腔镜手术麻醉中的应用

目的探讨瑞芬太尼复合丙泊酚用于腹腔镜手术的麻醉效果。方法选取本院2011年1月～2012年12月收治的150例门诊患者为临床研究对象,将所有患者随机分为观察组和对照组,观察组采用瑞芬太尼复合丙泊酚麻醉诱导和维持,对照组以芬太尼替代瑞芬太尼进行麻醉诱导和维持。观察两组患者在术中的血流动力学变化和药物起效时间,患者的清醒时间、麻醉的恢复时间和镇痛药物的应用时间,以综合比较其麻醉效果。结果两组患者在整个手术过程中,其HR的变化差异无统计学意义（P〉0.05）,说明两组均可有效保持HR平稳。观察组在整个手术过程中,MAP的变化差异无统计学意义（P〉0.05）,对照组的MAP变化较大,在诱导后和插管1h后尤为明显,差异有统计学意义（P〈0.05）。观察组在药物起效时间、患者清醒时间、麻醉药恢复时间和镇痛药应用时间等指标上均优于对照组,差异有统计学意义（P〈0.05）。结论瑞芬太尼与传统药物芬太尼相比,能提高麻醉效果,可促进患者术后的恢复和苏醒,且术中血流动力学也更为稳定,值得临床推广应用。

Application of remifentanil combined with propofol in anesthesia of laparoscopic surgery

Objective To investigate the anesthetic effect of remifentanil combined with propofol for laparoscopic surgery.Methods 150 outpatients admitted to our hospital from January 2011 to December 2012 were selected as the clinical study subjects.All the patients were randomly divided into the observation group and the control group.The observation group received remifentanil combined with propofol for anesthesia induction and maintenance and the control group received fentanyl in place of remifentanil for anesthesia induction and maintenance.The intraoperative hemodynamic changes and drug onset time,the patient’s recovery time,the recovery time of anesthesia and the application time of analgesic drugs of the two groups of patients were observed in order to compare their anesthetic effect comprehensively.Results During the whole surgical process,the differences in HR change of the two groups were not significantly different（P＆gt;0.05）,indicating that both groups could effectively maintain stable HR.In the observation group,during the whole surgical process,the MAP change difference was not significantly different（P＆gt;0.05）,but in the control group,the MAP change was large,especially after induction and 1 hour after intubation,wand the difference was statistically significant（P＆lt;0.05）.The observation group was better than the control group in the drug onset time,patient sober time,recovery time of anesthetics and application time of analgesics,with statistically significant differences（P＆lt;0.05）.Conclusion Compared to traditional drug fentanyl,remifentanil can improve the anesthetic effect and promote the postoperative recovery and revival and it has more stable intraoperative hemodynamics,thereby worthy of popularization and application in clinical work.