瑞芬太尼复合丙泊酚对 LC 术中血流动力学的影响

【目的】观察瑞芬太尼复合丙泊酚对腹腔镜胆囊切除术（LC ）术中患者血流动力学的影响。【方法】在本院接受LC的患者110例，根据其麻醉方式分为丙泊酚麻醉组和复合麻醉组，其中丙泊酚组给予丙泊酚静脉麻醉，复合麻醉组给予瑞芬太尼复合异丙酚麻醉。观察比较两组患者手术中血流动力学以及麻醉效果的差异。【结果】两组患者入手术室时（T0）收缩压（SBP）、舒张压（DBP），平均动脉压（MAP），血氧饱和度（SpO2）水平相比较差异无显著性（P＞00．5），丙泊酚组麻醉诱导即刻（T1）、气管插管即刻（T2）、切皮即刻（T3）、手术中（T4）、缝皮即刻（T5）和拔管即刻（T6）患者的DBP和MAP水平较复合麻醉组低（P＜00．5），且波动明显，而两组患者的SpO2水平相比较差异无显著性（P＞00．5）；两组患者术后12 h和24 h的VAS得分和Ramsay得分均较术后4 h降低，且手术后4 h、12 h和24 h ，复合麻醉组VAS 得分低于对照组（P＜00．5），两组患者的Ramsay得分相比较差异无显著性（P＞00．5）；复合麻醉组患者唤醒时间和拔管时间均较丙泊酚组短，且差异具有显著性（P＜00．5）。【结论】瑞芬太尼复合丙泊酚对LC术中血流动力学影响较小，且麻醉效果较好，值得在临床推广应用。

Effect of Remifentanil Combined with Propofol on Hemodynamics During Laparoscopic Chole-cystectomy Operation

Objective]To observe the effect of remifentanil combined with propofol on hemodynamics dur‐ing laparoscopic cholecystectomy (LC) operation .Methods]One hundred and ten patients who received LC surgery at our hospital were selected as the study subjects and divided according to the mode of anesthesia into the propofol anesthesia group (the control group) and the combined anesthesia group (the observation group) . Patients in the propofol group were given propofol anesthesia intravenously ,while patients in the combined an‐esthesia group were given remifentanil combined with propofol anesthesia .The differences between the hemo‐dynamics and anesthetic effects between the two groups were observed and compared .Results]Before surgery (T0 ) ,SBP ,DBP ,and MAP levels were not significantly different between the two groups( P >0 0.5) .The levels of MAP and DBP in patients of the propofol group at ,T1 (anesthesia onset) ,T2 (intubation) ,T3 (inci‐sion) ,T4 (operation) ,T5 (skin closure) ,and T6 (extubation) were lower than those of patients of the com‐bined anesthesia group( P < 0 .05) ,and the fluctuations was obvious .However ,there was no significant difference between the two groups of patients with SpO2 .The VAS and Ramsay scores of patients in the two groups at 12h and 24h postoperative were lower than at 4h postoperative .The VAS scores of patients in the combined anesthesia group at 4h ,12h and 24h after surgery were lower than those of patients in the propofol group( P <0 0.5)however ,at those time points the Ramsay scores of patients in the two groups showed no significant difference ( P >0 0.5) .The wake‐up time and extubation time of combined anesthesia patients were shorter compared to those of propofol patients ;the difference was statistically significant ( P <0 0.5) .Con‐clusion]Remifentanil combined with propofol has little effect on the hemodynamics during LC operation ,and the effect of anesthesia is better I.t is worthy of being popularized in clinical application .